Abstract
Partial splenectomy was carried out in four children with homozygous sickle cell disease and eight children with sickle cell beta thalassaemia. It was performed in order to preserve splenic contribution to the host defence against infections while suppressing hypersplenism or the risk of recurrence of acute splenic sequestration. Indications for this surgical operation were acute splenic sequestration (n = 1), hypersplenism (n = 5), and acute splenic sequestration and hypersplenism (n = 6). Surgery was uneventful in 11 patients. A significant reduction of blood requirements and a significant decrease of the number of hospitalisations/patient/year were observed after splenectomy. No recurrence of hypersplenism or acute splenic sequestration occurred and no severe infection was noticed during the follow up period after surgery (mean (SD) 4.2 (2.8) years; range 6 months-7 years). Mean haemoglobin concentration and leucocyte and platelet counts increased after surgery. The benefit of partial splenectomy compared with total splenectomy to treat acute splenic sequestration or hypersplenism in sickle cell disease is discussed.
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- Corry J. M., Polhill R. B., Jr, Edmonds S. R., Johnston R. B., Jr Activity of the alternative complement pathway after splenectomy: comparison to activity in sickle cell disease and hypogammaglobulinemia. J Pediatr. 1979 Dec;95(6):964–969. doi: 10.1016/s0022-3476(79)80284-x. [DOI] [PubMed] [Google Scholar]
- Eichner E. R. Splenic function: normal, too much and too little. Am J Med. 1979 Feb;66(2):311–320. doi: 10.1016/0002-9343(79)90554-0. [DOI] [PubMed] [Google Scholar]
- Emond A. M., Collis R., Darvill D., Higgs D. R., Maude G. H., Serjeant G. R. Acute splenic sequestration in homozygous sickle cell disease: natural history and management. J Pediatr. 1985 Aug;107(2):201–206. doi: 10.1016/s0022-3476(85)80125-6. [DOI] [PubMed] [Google Scholar]
- Emond A. M., Morais P., Venugopal S., Carpenter R. G., Serjeant G. R. Role of splenectomy in homozygous sickle cell disease in childhood. Lancet. 1984 Jan 14;1(8368):88–91. doi: 10.1016/s0140-6736(84)90014-x. [DOI] [PubMed] [Google Scholar]
- Heier H. E. Splenectomy and serious infections. Scand J Haematol. 1980 Jan;24(1):5–12. doi: 10.1111/j.1600-0609.1980.tb01311.x. [DOI] [PubMed] [Google Scholar]
- Kinney T. R., Ware R. E., Schultz W. H., Filston H. C. Long-term management of splenic sequestration in children with sickle cell disease. J Pediatr. 1990 Aug;117(2 Pt 1):194–199. doi: 10.1016/s0022-3476(05)80529-3. [DOI] [PubMed] [Google Scholar]
- Revillon Y., Girot R. Désartérialisation partielle de la rate et splénectomie partielle chez l'enfant. Presse Med. 1985 Feb 16;14(7):423–425. [PubMed] [Google Scholar]
- Rogers D. W., Clarke J. M., Cupidore L., Ramlal A. M., Sparke B. R., Serjeant G. R. Early deaths in Jamaican children with sickle cell disease. Br Med J. 1978 Jun 10;1(6126):1515–1516. doi: 10.1136/bmj.1.6126.1515. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Topley J. M., Rogers D. W., Stevens M. C., Serjeant G. R. Acute splenic sequestration and hypersplenism in the first five years in homozygous sickle cell disease. Arch Dis Child. 1981 Oct;56(10):765–769. doi: 10.1136/adc.56.10.765. [DOI] [PMC free article] [PubMed] [Google Scholar]
- de Montalembert M., Girot R., Revillon Y., Jan D., Adjrad L., Ardjoun F. Z., Belhani M., Najean Y. Partial splenectomy in homozygous beta thalassaemia. Arch Dis Child. 1990 Mar;65(3):304–307. doi: 10.1136/adc.65.3.304. [DOI] [PMC free article] [PubMed] [Google Scholar]