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[Complications of splenectomy in childhood (author's transl)]
Insights
This study on 161 children post-splenectomy found high rates of severe infections like pneumonia and sepsis (15%), with a 31.8% lethality in infected cases. Postoperative monitoring of blood counts and immunoglobulins is crucial.
Area of Science:
- Pediatric Surgery
- Immunology
- Infectious Diseases
Context:
- Splenectomy in children is performed for various conditions including spherocytosis, Hodgkin's disease, traumatic spleen rupture, portal hypertension, and idiopathic thrombocytopenia.
- Postoperative complications following pediatric splenectomy can range from minor wound infections to severe systemic infections.
Purpose:
- To evaluate the incidence of severe postoperative infections and associated lethality in children after splenectomy.
- To assess key immunological and hematological parameters in children following splenectomy.
Summary:
- A cohort of 161 children underwent follow-up after splenectomy.
- 15% of patients experienced severe infections (pneumonia, meningitis, sepsis), with a 31.8% lethality rate among infected children.
- Postoperative assessment included leukocyte, thrombocyte, and erythrocyte counts, immunoglobulins (IgG, IgA, IgM, IgE), complement components (C3, C4), and serum proteins (alpha 1-antitrypsin, transferrin).
Impact:
- Highlights the significant risk of severe infections and mortality in children post-splenectomy, emphasizing the need for vigilant monitoring.
- Provides a comprehensive dataset of immunological and hematological markers for children after splenectomy, aiding in understanding long-term immune function.
- Informs clinical practice regarding the management and follow-up protocols for pediatric patients undergoing splenectomy.
Abstract:
161 children followed up postoperatively following splenectomy, 29% had spherocytosis, 14% Hodgkin's disease, 12% traumatic rupture of the spleen, 11% portal hypertension and 7% idiopathic thrombocytopenia. Postoperatively a slight wound infection occurred in 5% of the children, while complications were seen in 2% which could be interpreted as directly caused by the operation; in 23 patients, however, (i.e. 15%), severely infections occurred such as pneumonia, meningitis and sepsis. The lethality rate of the infected children was 31.8%. Postoperatively we determined the leucocyte count, thrombocytes and erythrocyte count, the immunoglobulins IgG, IgA, IgM and IgE, the serum concentrations of the complement components C3, C4 and the serum proteins alpha 1-antitrypsin and transferrin. The data obtained were compared with the corresponding data reported in the literature.