Iatrogenic injuries resulting in incidental splenectomy, what lies beneath?

Objectives: Surgical reports on incidental splenectomy usually lack necessary details particularly during any other abdominal operative procedures. This retrospective study was conducted in order to analyze our institutional clinical experience in iatrogenic splenectomy and to evaluate the predisposing factors. Patients and Methods: The patients who underwent splenectomy were retrospectively evaluated over a ten-year period. Among these patients, iatrogenically splenectomized cases were reviewed for demographic features, incision types, primary operation procedures, locations, and the mechanism of the injury. Results: The evaluation involved 19/322 patients (5.9%) with a mean age of 63.9 years. Upper gastrointestinal procedures (63%) and midline incision (72%) were found to be the most common factors leading to splenic trauma in patients with iatrogenic splenic injury. In our series, the main contributive factor for splenic injury was splenic traction (52%) during surgery. The most frequent location of the injury was the splenic hilus (8 patients). Conclusion: Splenectomy procedures may result in serious complications in both the postoperative period and long term follow-up due to immunologic defects. To avoid such complications, the appropriate incision type depending on the type of surgery and effective retractor should be determined. If complications occur, organ-preserving procedure is recommended, using high technical advances