[Risk of infection and surgical consequences of splenic loss in childhood].

Among 1882 splenectomized children with a mean follow-up period of more than 5 years the incidence of sepsis was 3.2% with a mortality of 1.4%. As expected the lowest risk (1.6%) was found in case of trauma. Susceptibility to sepsis increases after splenectomy caused by severe disease. It was highest (9.8%) in case of M. Hodgkin, portal hypertension and thalassemia. The younger the patient the higher the risk of PSI. 55% of the affected patients suffered from sepsis within the first two years, 35% after three up to six years. Vaccination and antibiotic prophylaxis are recommended including information about the risk of sepsis. Preservation of orthotopic splenic tissue, if indicated, should be the surgical consequence in childhood.