Abstract
Splenic tissue reimplantation employing the omental implantation technique was applied in 23 patients undergoing splenectomy for traumatic or iatrogenic splenic injury. Four complications were encountered after autotransplantation (17.4%). Two of these consisted of small bowel obstruction due to postoperative adhesions and were successfully managed by lysis of the adhesions. The other two complications were aseptic necrosis of the splenic transplants and were treated with ablation of the autolysed transplants. A case of abnormal splenic tissue reimplantation in a male patient with unsuspected myelofibrosis is also discussed. He underwent an emergency laparotomy for rupture of a subcapsular splenic haematoma. It is concluded that splenic tissue implantation in the greater omentum is associated with important early morbidity and this should be taken into account whenever application of the method is considered.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Christenson J. T., Owunwanne A., Al-Hassan E. E., Ryd W. Regeneration and function of autotransplantation of splenic tissue after splenectomy. World J Surg. 1986 Oct;10(5):860–866. doi: 10.1007/BF01655260. [DOI] [PubMed] [Google Scholar]
- Chu D. Z., Nishioka K., el-Hagin T., Hopfer R. L., Romsdahl M. M. Effects of tuftsin on postsplenectomy sepsis. Surgery. 1985 Jun;97(6):701–706. [PubMed] [Google Scholar]
- Cooney D. R., Dearth J. C., Swanson S. E., Dewanjee M. K., Telander R. L. Relative merits of partial splenectomy, splenic reimplantation, and immunization in preventing postsplenectomy infection. Surgery. 1979 Oct;86(4):561–569. [PubMed] [Google Scholar]
- Cooney D. R., Michalak W. A., Michalak D. M., Fisher J. E. Comparative methods of splenic preservation. J Pediatr Surg. 1981 Jun;16(3):327–338. doi: 10.1016/s0022-3468(81)80690-2. [DOI] [PubMed] [Google Scholar]
- Deitch E. A., O'Neal B. Neutrophil function in adults after traumatic splenectomy. J Surg Res. 1982 Aug;33(2):98–102. doi: 10.1016/0022-4804(82)90013-0. [DOI] [PubMed] [Google Scholar]
- Francke E. L., Neu H. C. Postsplenectomy infection. Surg Clin North Am. 1981 Feb;61(1):135–155. doi: 10.1016/s0039-6109(16)42339-x. [DOI] [PubMed] [Google Scholar]
- Keramidas D. C. The ligation of the splenic artery in the treatment of traumatic rupture of the spleen. Surgery. 1979 May;85(5):530–533. [PubMed] [Google Scholar]
- Keramidas D. C., Voyatzis N., Anagnostou D., Stavrides J., Koutoulides C., Ziros A. Ligation of the splenic artery; effects on the injured spleen and its function. J Pediatr Surg. 1980 Feb;15(1):38–41. doi: 10.1016/s0022-3468(80)80400-3. [DOI] [PubMed] [Google Scholar]
- Kusminsky R. E., Chang H. H., Hossino H., Zekan S. M., Boland J. P. An omental implantation technique for salvage of the spleen. Surg Gynecol Obstet. 1982 Sep;155(3):407–408. [PubMed] [Google Scholar]
- Morgenstern L. Let the preserver of spleens beware. Surg Gynecol Obstet. 1982 Jan;154(1):81–81. [PubMed] [Google Scholar]
- O'Neal B. J., McDonald J. C. The risk of sepsis in the asplenic adult. Ann Surg. 1981 Dec;194(6):775–778. doi: 10.1097/00000658-198112000-00020. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Oakes D. D. Splenic trauma. Curr Probl Surg. 1981 Jun;18(6):341–401. doi: 10.1016/s0011-3840(81)80001-9. [DOI] [PubMed] [Google Scholar]
- Orda R., Barak J., Baron J., Spirer Z., Wiznitzer T. Postsplenectomy splenic activity. Ann Surg. 1981 Dec;194(6):771–774. doi: 10.1097/00000658-198112000-00019. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Patel J., Williams J. S., Shmigel B., Hinshaw J. R. Preservation of splenic function by autotransplantation of traumatized spleen in man. Surgery. 1981 Oct;90(4):683–688. [PubMed] [Google Scholar]
- Pearson H. A., Johnston D., Smith K. A., Touloukian R. J. The born-again spleen. Return of splenic function after splenectomy for trauma. N Engl J Med. 1978 Jun 22;298(25):1389–1392. doi: 10.1056/NEJM197806222982504. [DOI] [PubMed] [Google Scholar]
- Sullivan J. L., Ochs H. D., Schiffman G., Hammerschlag M. R., Miser J., Vichinsky E., Wedgwood R. J. Immune response after splenectomy. Lancet. 1978 Jan 28;1(8057):178–181. doi: 10.1016/s0140-6736(78)90612-8. [DOI] [PubMed] [Google Scholar]
- West K. W., Grosfeld J. L. Postsplenectomy sepsis: historical background and current concepts. World J Surg. 1985 Jun;9(3):477–483. doi: 10.1007/BF01655284. [DOI] [PubMed] [Google Scholar]