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Updated: Jun 14, 2026
Robot-Assisted Laparoscopic Splenectomy In Children: A Case Report with Literature Review
Published on: March 27, 2026
Clinical events after surgical splenectomy in children with sickle cell anemia
Ram Kalpatthi1, Ian D Kane, Ibrahim F Shatat
1Division of Pediatric Hematology and Oncology, The Children's Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108, USA. rvkalpatthi@cmh.edu
Insights
Splenectomy for sickle cell anemia (SCA) in children shows a low sepsis risk but increases complications like vaso-occlusive pain crises (VOC), acute chest syndrome (ACS), and stroke risk.
Area of Science:
- Pediatric Hematology
- Sickle Cell Disease Management
- Surgical Complications
Background:
- Sepsis is a major concern after splenectomy in children with sickle cell anemia (SCA).
- Understanding post-splenectomy complication rates is crucial for managing SCA patients.
Purpose of the Study:
- To determine the actual prevalence of sepsis and other complications following splenectomy for acute splenic sequestration crisis (ASSC) in children with SCA.
- To evaluate the long-term outcomes and risks associated with splenectomy in this population.
Main Methods:
- Retrospective review of medical records for children with SCA (HbSS) who underwent splenectomy for ASSC.
- Analysis of post-splenectomy complications including sepsis, acute chest syndrome (ACS), vaso-occlusive pain crises (VOC), and stroke or abnormal transcranial Doppler (TCD) findings.
Main Results:
- Fifty-eight children with SCA underwent splenectomy for ASSC (median age 2 years).
- Sepsis incidence did not differ pre- and post-splenectomy; however, VOC and ACS occurred more frequently after surgery.
- Stroke or abnormal TCD findings were observed in 24% of patients post-splenectomy.
Conclusions:
- Splenectomy for ASSC in children with SCA is associated with a low risk of sepsis.
- Increased rates of VOC, ACS, and stroke or abnormal TCDs necessitate careful monitoring and management post-splenectomy.
Purpose:
Despite advances in immune prophylaxis, sepsis remains the most feared complication following splenectomy for acute splenic sequestration crisis (ASSC) in children with sickle cell anemia (SCA). We seek to investigate the true prevalence of sepsis and other complications of splenectomy in this patient population.
Methods:
We reviewed the records of children with SCA (HbSS) who underwent splenectomy for ASSC between 1993 and 2008 at a single institution.
Results:
Fifty-eight patients (33 males) at a median age of 2 years at splenectomy were included with an average post-splenectomy follow-up of 6.4 years (range 6 months-14 years). Thirty-seven patients (64%) underwent laparoscopic splenectomy, and acute chest syndrome (ACS) was the most common post-operative complication (6.9%). There was no difference in the incidence of sepsis pre- and post-splenectomy. The occurrence of vaso-occlusive pain crises (VOC) and ACS was significantly higher after splenectomy. In addition, 14 patients (24%) developed stroke (n = 5) or an abnormal transcranial Doppler (TCD) (n = 9) after splenectomy.
Conclusion:
Our data suggest that splenectomy can be safely performed in children with SCA given a low risk of sepsis. However, the increased incidence of VOC, ACS, and stroke or abnormal TCDs after splenectomy remains a concern.
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