BACKGROUND: Splenic complications of sickle-cell disease (SCD) are associated with morbidity, and in some it may lead to mortality. This paper presents our experience with 43 patients with SCD who had splenectomy as part of their management. PATIENTS AND METHODS: The records of 43 patients with SCD who had splenectomy were examined for age at operation, sex, hemoglobin (Hb) electrophoresis, indication for splenectomy, pre- and postoperative medications, operative procedures, and postoperative complications. RESULTS: The indications for splenectomy were acute splenic sequestration crisis (ASSC) in 21 patients, hypersplenism in 15, and splenic abscess in 7. In 17 patients, the spleen was also found to be massively enlarged causing discomfort and intervening with everyday activity. For those with hypersplenism, there was a significant postoperative increase in total Hb (P < 0.0001), hematocrit (P < 0.0001), white blood cells (P < 0.0001), and platelet count (P < 0.0001). CONCLUSIONS: With careful perioperative management and proper follow-up, splenectomy in patients with SCD is beneficial in reducing their transfusion requirements and its attendant risks, eliminating the discomfort from mechanical pressure of the enlarged spleen, avoiding the risks of ASSC, and managing splenic abscess.
BACKGROUND: Splenic complications of sickle-cell disease (SCD) are associated with morbidity, and in some it may lead to mortality. This paper presents our experience with 43 patients with SCD who had splenectomy as part of their management. PATIENTS AND METHODS: The records of 43 patients with SCD who had splenectomy were examined for age at operation, sex, hemoglobin (Hb) electrophoresis, indication for splenectomy, pre- and postoperative medications, operative procedures, and postoperative complications. RESULTS: The indications for splenectomy were acute splenic sequestration crisis (ASSC) in 21 patients, hypersplenism in 15, and splenic abscess in 7. In 17 patients, the spleen was also found to be massively enlarged causing discomfort and intervening with everyday activity. For those with hypersplenism, there was a significant postoperative increase in total Hb (P < 0.0001), hematocrit (P < 0.0001), white blood cells (P < 0.0001), and platelet count (P < 0.0001). CONCLUSIONS: With careful perioperative management and proper follow-up, splenectomy in patients with SCD is beneficial in reducing their transfusion requirements and its attendant risks, eliminating the discomfort from mechanical pressure of the enlarged spleen, avoiding the risks of ASSC, and managing splenic abscess.
Authors: Brian R Englum; Jennifer Rothman; Sarah Leonard; Audra Reiter; Courtney Thornburg; Mary Brindle; Nicola Wright; Matthew M Heeney; C Jason Smithers; Rebeccah L Brown; Theodosia Kalfa; Jacob C Langer; Michaela Cada; Keith T Oldham; J Paul Scott; Shawn D St Peter; Mukta Sharma; Andrew M Davidoff; Kerri Nottage; Kathryn Bernabe; David B Wilson; Sanjeev Dutta; Bertil Glader; Shelley E Crary; Melvin S Dassinger; Levette Dunbar; Saleem Islam; Manjusha Kumar; Fred Rescorla; Steve Bruch; Andrew Campbell; Mary Austin; Robert Sidonio; Martin L Blakely; Henry E Rice Journal: J Pediatr Surg Date: 2015-10-23 Impact factor: 2.545
Authors: Abdulrahman Alsultan; Mohammed K Alabdulaali; Paula J Griffin; Ahmed M Alsuliman; Hazem A Ghabbour; Paola Sebastiani; Waleed H Albuali; Amein K Al-Ali; David H K Chui; Martin H Steinberg Journal: Br J Haematol Date: 2013-11-13 Impact factor: 6.998
Authors: Sari Peretz; Leonid Livshits; Etheresia Pretorius; Asya Makhro; Anna Bogdanova; Max Gassmann; Ariel Koren; Carina Levin Journal: Front Physiol Date: 2022-08-29 Impact factor: 4.755