[Postsplenectomy infection and immunologic aspects of splenectomy]

Of 619 trauma patients undergoing splenectomy, 503 lived more than 10 days. In this group, 114 patients (22.7%) developed systematic sepsis and 36 patients (7.2%) succumbed from sepsis. Septic morbidity and mortality rates in splenectomized patients were significantly greater than those in 2180 consecutive trauma patients treated in 1978-1979. Septic mortality rate in septic patients was significantly greater than that in 2180 consecutive trauma patients. Septic mortality rate in the patients whose trauma were seen only in the spleen or associated with only one organ injury was also very high. Long-term follow-up information was obtained in 242 splenectomized patients with a mean patient follow-up interval of 4.4 years. Severe bacterial infections have occurred in six patients. Thus far, there have been no deaths from overwhelming sepsis. Of interest, 10% of the patients complained of more severe viral infection following splenectomy. On the other hand, the incidence of postoperative infection in the patients who underwent total gastrectomy with splenectomy was not different from that of the patients who underwent total gastrectomy without splenectomy. However, the incidence of the postoperative infection in the splenectomized patients together with total gastrectomy was greater than that of the the splenectomized patients in trauma.