Splenectomy and myelofibrosis

Two patients are reported in whom splenectomy during the course of myelofibrosis was followed by rapid deterioration in the function of a previously involved liver, and was characterised by refractory ascites, increasing jaundice, and death. It is important to recognise this complication, since ectopic haematopoiesis can be demonstrated on liver biopsy and, perhaps, controlled with radiotherapy or cytotoxic chemotherapy.