[Splenectomy for splenomegaly in Ivory Coast. Indications and short term results]

To study the indications and evaluate the short term results of splenectomy for splenomegaly.

This retrospective analysis concerned 31 males and 21 feméles with a mean age of 30,5 yersin old, from February 1998 to December 2003. The aetiologies of splenomegaly were parasites (n=6), benign haematological diseases (n= 24), haematological malignancies (n=6), infections (n=3) and cysts (n=3). The indications were due to hypersplenism in 39 cases (79,5%), risk of splenic rupture in 46 cases (88,5%), infection or risk of infection in 3 cases and painful splenomegaly in 3 cases. 49 nine patients underwent complete splenectomy and the 3 remaining had a partial splenectomy. A spleno-renal shunt in three cases, mesenterico-adrenal shunt and mesenterico-cave shunt were associated for portal hypertension. A lengthy penicillinotherapy in all the patients and thromboembolic prevention in some were performed.

The mean hospital stay was 6.3 days. Correction of cytopenia and permanent pain relief occurred in all cases. One patient died from intraoperative haemorrhage and 2 other from unknown cause postoperatively (09%). Morbidity was due to hyperthermy in 3 cases, abdominal haemorrhage by splenic vessel ligation leakage and bridles obstruction in one case.

This study shows that hypersplenism constituted the mean indication of splenectomy. Its low mortality and morbidity suggest that it might be usually used in our practice. These results may be improve by laparoscopic splenectomy and systematic prevention of postoperative complications.