Original article Results of Splenectomy Performed on a Group of 91 Children

In the period 1971-1990 91 children underwent splenectomies in the University Hospital of Nijmegen, The most important indications are hereditary spherocytosis, Hodgkin's disease and very severe immune thrombocytopenic purpura (ITP). Splenec tomy after a traumatic rupture of the spleen has become less frequent: from 2 0 % in 1971-1980 to 4 % in 1981-1990. Short-term complica tions included thrombocytosis (84%), fever without an obvious cause (46 %), which is quite regularly seen in patients suffering from Hodg kin's disease (48 %), and infections of the respiratory tract in 10 % of the patients. The platelet count shows a steady increase in the first nine post-operative days. No tliromboembolic complications were seen. Based upon the literature there seems to be no reason at this moment for anti-platelet aggregation therapy when platelet counts arc below 1000xl09 /l. More information about long-term complications was obtained through a questionnaire completed by general practitioners. The morbidity through overwhelming post splenectomy infection (OPSI) is 3.8 % (3/79), the mortality of OPSi is 2.5 % (2/79). Under lying diseases, especially those which involve the immunological system as auto immune haemolytic anemia (AIHA), seem to play an important role in the possible development of OPSI (morbidity 2/11, 18 %). Key words Splenectomy, indications, complications- OPS