Outcome and sepsis after splenectomy in adults

Of 277 splenectomies performed over 10 years, 24.2 percent were incidental. Operative mortality in this group was 14.9 percent, which is higher than that encountered after splenectomy for any other indication. A majority of the deaths were from septic causes, and infectious complications accounted for most of the morbidity as well. This finding is in marked contrast to the paucity of infectious morbidity and mortality in patients with all other splenectomies. Of the 251 patients who survived these operations, follow-up was available on 175. Twenty-six had received Pneumovax, and 4 of these patients died, none from infectious causes. There were 20 septic deaths among the 149 unvaccinated patients, including 3 cases of fulminant pneumococcal sepsis.