Persistence of vacuolated RBCs after splenectomy in adults

Children undergoing splenectomy after trauma commonly have few vacuolated RBCs, suggesting a recurrence of splenic activity. We assayed RBCs with vacuoles in 17 adults who had splenectomies for trauma and 15 adults who underwent splenectomy for nontraumatic indications. Vacuolated cells averaged 29.0% +/- 1.0% (SE) in adults having emergency splenectomies and 32.3% +/- 2.0% in those having elective splenectomies. One adult who had a splenectomy for trauma had few RBCs with vacuoles, and a technetium Tc 99m sulfur colloid spleen scan showed one accessory spleen. These findings suggest that recurrence of splenic activity in adults, unlike in children, is an uncommon sequela of splenic rupture.