Splenic implants: evaluation with radionuclide methods

The viability of omental splenic implants placed in 16 patients who had undergone splenectomy was assessed with 37 technetium-99m tin colloid studies and five studies with Tc-99m-labeled denatured red blood cells (RBCs). Indications for splenectomy included trauma in eight patients, schistosomal (Bilharzial) portal hypertension in six, splenic artery aneurysm in one, and Wiskott-Aldrich syndrome in one. Studies were done within the 1st month and at various intervals up to 13 months after surgery. Implants in five of eight trauma patients were seen during the 1st month, and implants in seven of seven were seen after 6 months (one patient could not be followed up). Three of six implants in cases of portal hypertension were seen in the 1st month and four of four at 6 months (two patients were not followed up). In two of the five studies with denatured RBCs, Tc-99m tin colloid study was also done 48 hours later; in these cases denatured RBCs were more successful in showing the implants. The authors conclude that radioisotopic procedures are valuable in following up the viability of splenic implants. The "take" of splenic implants in patients with schistosomiasis is equally successful to that in trauma patients.