Abstract
981 consecutive splenectomies at The New York Hospital were reviewed. 18.9% were removed incidental to some other procedure, either to facilitate exposure or because of uncontrolled bleeding from capsular tears. The primary operation with which this was most frequently associated was gastric resection for peptic ulcer disease, accounting for 20.5% of the spleens so removed. Conversely, the incidental splenectomy was noted in only 0.91% of all gastrectomies and 1.4% of all left colectomies designated as nonradical procedures. It is therefore seldom a necessary procedure. Incidental splenectomy is more frequent when midline abdoiminal incisions are employed, less frequent with paramedian or left rectus splitting incisions. 85% of the spleens removed incidentally were grossly and microscopically unremarkable; lacerations most probably result from excessive manipulation rather than pathological changes predisposing to rupture. The postoperative morbidity and mortality is discussed and is felt to be increased significantly by the incidental splenectomy.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- BOZZELL J. D., POWELL N. B. Splenectomy associated with surgery of the left kidney. J Urol. 1954 Feb;71(2):183–191. doi: 10.1016/S0022-5347(17)67772-3. [DOI] [PubMed] [Google Scholar]
- BROWN M. J., WOODWARD B., MEHNERT J. H. SURGICAL TRAUMA TO THE SPLEEN. Am Surg. 1963 Oct;29:710–712. [PubMed] [Google Scholar]
- CALAMEL P. M., CLEVELAND H. C., WADDELL W. R. Ruptured spleen. Surg Clin North Am. 1963 Apr;43:445–455. doi: 10.1016/s0039-6109(16)36938-9. [DOI] [PubMed] [Google Scholar]
- Devlin H. B., Evans D. S., Birkhead J. S. The incidence and morbidity of accidental injury to the spleen occurring during abdominal surgery. Br J Surg. 1969 Jun;56(6):446–448. doi: 10.1002/bjs.1800560612. [DOI] [PubMed] [Google Scholar]
- FERGUSON L. K., BRAVO J. L., NUSBAUM M. Comparison of surgical treatments of duodenal ulcer. Results of 50 per cent gastrectomy and vagotomy compared to results of 75 per cent gastric resection for duodenal ulcer. Arch Surg. 1961 Apr;82:627–633. doi: 10.1001/archsurg.1961.01300100141016. [DOI] [PubMed] [Google Scholar]
- Fabri P. J., Metz E. N., Nick W. V., Zollinger R. M. Proceedings: A quarter century with splenectomy. Changing concepts. Arch Surg. 1974 Apr;108(4):569–575. doi: 10.1001/archsurg.1974.01350280169028. [DOI] [PubMed] [Google Scholar]
- PECK D. A., JACKSON F. C. SPLENECTOMY AFTER SURGICAL TRAUMA. Arch Surg. 1964 Jul;89:54–65. doi: 10.1001/archsurg.1964.01320010056007. [DOI] [PubMed] [Google Scholar]
- RICH N. M., LINDNER H. H., MATHEWSON C., Jr SPLENECTOMY INCIDENTAL TO IATROGENIC TRAUMA. Am J Surg. 1965 Aug;110:209–217. doi: 10.1016/0002-9610(65)90014-0. [DOI] [PubMed] [Google Scholar]
- ZOLLINGER R. M., STEWART W. R., WILLIAMS R. D. Indications for splenectomy. Postgrad Med. 1960 Feb;27:148–157. doi: 10.1080/00325481.1960.11712792. [DOI] [PubMed] [Google Scholar]
- ZOLLINGER R. M. Technic of vagotomy, hemigastrectomy and Billroth I anastomosis. Am J Surg. 1963 Mar;105:413–422. doi: 10.1016/0002-9610(63)90356-8. [DOI] [PubMed] [Google Scholar]