Diagnosis of liver-spleen abscesses in children--with emphasis on ultrasound for the initial and follow-up examinations.

Abstract

Seven children with hepatic and one with splenic abscess were evaluated using at least two of the following imaging modalities: ultrasound, radionuclide liver-spleen scan, computed tomography (CT) and angiography. Seven children had pyogenic, and one mixed pyogenic-amebic abscess. In all cases ultrasound demonstrated the lesions, which in 6/7 of hepatic abscesses were located only to the right liver lobe. 99mTc -sulphur colloid liver-spleen scans were positive in 4/4 cases while 67Ga failed to demonstrate 2/2 lesions. CT gave additional information in regard to etiology of lesions observed at ultrasound examination. Angiography performed in four cases showed vessel displacement by poorly vascularized mass lesions and arterioportal shunting in one but, overall, did not contribute to patient management. In clinically suggested hepatic-splenic abscesses, ultrasound together with CT will provide the diagnostic information needed for treatment. Follow-up studies should be performed by ultrasound.