Sonography of pyogenic splenic abscess.

Pyogenic splenic abscess is an uncommon lesion associated with high mortality. Diagnosis may be difficult, especially in deep-seated abscesses. Plain radiographs and nuclear medicine techniques may be helpful, but can be insufficiently specific. Sonography, which images morphologic changes, is useful in assessing splenic abscesses. Five of six abscesses had a predominantly anechoic pattern with internal foci of higher echogenicity. In one gas-containing lesion, there were high amplitude echoes throughout the abscess. The abscesses were easily distinguishable from the surrounding homogeneous normal spleen. Sonography, while not definitive, is an effective tool in reaching an early diagnosis of splenic abscess. This allows prompt splenectomy, ameliorating prognosis.