Splenectomy in patients with sickle-cell disease

被引:22
作者
AlSalem, AH
Qaisaruddin, S
Nasserallah, Z
AlDabbous, I
AlJama, A
机构
[1] QATIF CENT HOSP, DEPT PEDIAT, QATIF, SAUDI ARABIA
[2] QATIF CENT HOSP, DEPT INTERNAL MED, QATIF, SAUDI ARABIA
关键词
D O I
10.1016/S0002-9610(96)00158-4
中图分类号
R61 [外科手术学];
学科分类号
摘要
BACKGROUND: Splenic complications of sickle-cell disease (SCD) are associated with morbidity, and in some it may lead to mortality. This paper presents our experience with 43 patients with SCD who had splenectomy as part of their management. PATIENTS AND METHODS: The records of 43 patients with SCD who had splenectomy were examined for age at operation, sex, hemoglobin (Hb) electrophoresis, indication for splenectomy, pre- and postoperative medications, operative procedures, and postoperative complications. RESULTS: The indications for splenectomy were acute splenic sequestration crisis (ASSC) in 21 patients, hypersplenism in 15, and splenic abscess in 7. In 17 patients, the spleen was also found to be massively enlarged causing discomfort and intervening with everyday activity. For those with hypersplenism, there was a significant postoperative increase in total Hb (P <0.0001), hematocrit (P <0.0001), white blood cells (P <0.0001), and platelet count (P <0.0001). CONCLUSIONS: With careful perioperative management and proper follow-up, splenectomy in patients with SCD is beneficial in reducing their transfusion requirements and its attendant risks, eliminating the discomfort from mechanical pressure of the enlarged spleen, avoiding the risks of ASSC, and managing splenic abscess.
引用
收藏
页码:254 / 258
页数:5
相关论文
共 40 条
[1]  
AL-SALEM A H, 1989, Indian Journal of Pediatrics, V56, P747, DOI 10.1007/BF02724458
[2]  
ALAWAMI SMSM, 1992, INT SURG, V77, P60
[3]   SPLENIC FUNCTION IN SICKLE-CELL DISEASE IN THE EASTERN PROVINCE OF SAUDI-ARABIA [J].
ALAWAMY, B ;
WILSON, WA ;
PEARSON, HA .
JOURNAL OF PEDIATRICS, 1984, 104 (05) :714-717
[4]  
ALAWAMY BH, 1987, SAUDI MED J, V8, P553
[5]  
ALSALEM AH, 1992, INT ORTHOP, V16, P398
[6]   EVALUATION OF SPLENIC EMBOLIZATION IN PATIENTS WITH PORTAL-HYPERTENSION AND HYPERSPLENISM [J].
ALWMARK, A ;
BENGMARK, S ;
GULLSTRAND, P ;
JOELSSON, B ;
LUNDERQUIST, A ;
OWMAN, T .
ANNALS OF SURGERY, 1982, 196 (05) :518-524
[8]   NON-SURGICAL DRAINAGE OF SPLENIC ABSCESS [J].
BERKMAN, WA ;
HARRIS, SA ;
BERNARDINO, ME .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1983, 141 (02) :395-396
[9]   NONSURGICAL SPLENECTOMY [J].
CASTANEDAZUNIGA, WR ;
HAMMERSCHMIDT, DE ;
SANCHEZ, R ;
AMPLATZ, K .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1977, 129 (05) :805-811
[10]   SPLENIC ABSCESS [J].
CHUN, CH ;
RAFF, MJ ;
CONTRERAS, L ;
VARGHESE, R ;
WATERMAN, N ;
DAFFNER, R ;
MELO, JC .
MEDICINE, 1980, 59 (01) :50-65