U Müller1, M Röthlin. 1. Departement Chirurgie, Universitätsspital Zürich.
Abstract
GOAL: Regeneration of the spleen after posttraumatic splenectomy has been described in the literature. The goal of this study was to determine the rate of splenosis, its effect on hematology and postoperative infections and the value of sonography in the diagnosis of splenosis. PATIENTS AND METHODS: Fifty patients were examined sonographically one to 14 years after splenectomy. They were questioned concerning infections and a blood count was done. Data concerning the grading of the splenic rupture, additional injuries and postoperative complications were collected from their charts. RESULTS: Splenosis was detected sonographically in 17 patients. It was seen more often, the more severe the injury of the spleen had been. Patients under 30 years in the splenosis group had a shorter ICU and hospital stay and significantly less postoperative infections. Fourteen of 17 patients with splenosis had no hematological changes, while 32 of 33 patients without splenosis demonstrated Howell-Jolly bodies and acanthocytes. CONCLUSIONS: Sonography is a reliable method for visualisation of splenosis. The latter seems to prevent the hematological changes usually found after splenectomy. It also seems to reduce the number of postoperative infections in young patients.
GOAL: Regeneration of the spleen after posttraumatic splenectomy has been described in the literature. The goal of this study was to determine the rate of splenosis, its effect on hematology and postoperative infections and the value of sonography in the diagnosis of splenosis. PATIENTS AND METHODS: Fifty patients were examined sonographically one to 14 years after splenectomy. They were questioned concerning infections and a blood count was done. Data concerning the grading of the splenic rupture, additional injuries and postoperative complications were collected from their charts. RESULTS:Splenosis was detected sonographically in 17 patients. It was seen more often, the more severe the injury of the spleen had been. Patients under 30 years in the splenosis group had a shorter ICU and hospital stay and significantly less postoperative infections. Fourteen of 17 patients with splenosis had no hematological changes, while 32 of 33 patients without splenosis demonstrated Howell-Jolly bodies and acanthocytes. CONCLUSIONS: Sonography is a reliable method for visualisation of splenosis. The latter seems to prevent the hematological changes usually found after splenectomy. It also seems to reduce the number of postoperative infections in young patients.