[Post-splenectomy infections and Pneumococcus vaccination in paediatric surgery (author's transl)].

Morbidity and lethality rates in pneumococal infections are higher among children with underlying diseases associated with restricted or absent splenic function. Vaccination with polyvalent vaccine is indicated in all children who are more than 2 years old and who have been splenectomized or have a congenital asplenia. Since protection by vaccination is 80% only, we combine the vaccination with penicillin prophylaxis for at present at least three to five years after splenectomy and draw the express attention of parents and family physicians to the limited nature of protection afforded by vaccination. An increase in the immunogenicity of polysaccharid antigen vaccine might lead to successful vaccination of children below 2 years of age who are notable for a particularly high risk of infection. First reports have been published in literature on the possibility of re-implantation of splenic tissue after post-traumatic rupture (17, 27, 28) so that it may become possible to employ this method additionally to pneumococcus vaccination. In case of haematological indication for splenectomy this should be postponed as far as possible until the child has completed his fifth year of life.