Colonic surgery. The splenic connection.

Colonic resections, particularly those that require mobilization of the splenic flexure, occasionally will lead to injury of the spleen. Under these circumstances, the abdominal surgeon has traditionally considered incidental splenectomy to be the only safe alternative. Currently, a better understanding of splenic physiology and its role in sepsis prevention has reversed this trend. These efforts to preserve splenic function have resulted in various options available to the surgeon, herein reviewed. The results obtained in 36 general surgical patients with splenic injuries suggest that the salvage of the spleen is a safe alternative. In situations where salvage is impossible, the surgeon can resort to omental autotransplantation of the removed spleen, a recently described technique of appealing simplicity. The results obtained with this procedure in 23 other patients are presented.