Total Splenectomy for Splenic Abscess in Pediatric Oncology: A Report of Two Cases

Splenic abscess is a relatively uncommon condition, especially in pediatric malignancies. The diagnosis of a splenic abscess is a clinical challenge due to low incidence. The condition is fatal if not diagnosed on time. We are reporting two cases with underlying immune suppression secondary to malignancy and multidrug-resistant sepsis with splenic abscesses as the focus. Both children had life-threatening sepsis and required total splenectomy as a life-saving measure. Postsplenectomy course was uneventful with clinical improvement, and chemotherapy was continued. High suspicion is necessary due to nonspecific presentation. The treatment of splenic abscess includes conservative management and percutaneous drainage. Splenectomy is generally not indicated; however, total splenectomy may be required in the setting of multiple splenic abscesses, also to prevent overwhelming infection in an immunocompromised setting.