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Splenectomy in patients with sickle-cell disease
A H al-Salem1, S Qaisaruddin, Z Nasserallah
1Department of Surgery, Qatif Central Hospital, Saudi Arabia.
American Journal of Surgery
|September 1, 1996
Summary
Splenectomy is a beneficial treatment for sickle-cell disease (SCD) complications like splenic sequestration crisis and abscess. Careful management reduces transfusion needs and risks associated with an enlarged spleen.
Area of Science:
- Hematology
- Surgical Management
- Sickle Cell Disease
Background:
- Splenic complications in sickle-cell disease (SCD) can lead to significant morbidity and mortality.
- This study details the experience with 43 SCD patients undergoing splenectomy.
Purpose of the Study:
- To evaluate the outcomes of splenectomy in patients with sickle-cell disease.
- To assess the benefits and risks of splenectomy for various splenic complications in SCD.
Main Methods:
- Retrospective review of 43 patients with SCD who underwent splenectomy.
- Data collected included age, sex, hemoglobin electrophoresis, indications for surgery, medications, procedures, and complications.
Main Results:
- Indications for splenectomy: 21 for acute splenic sequestration crisis (ASSC), 15 for hypersplenism, 7 for splenic abscess.
- 17 patients had massively enlarged spleens causing discomfort.
- Hypersplenism cases showed significant postoperative increases in Hb, hematocrit, WBC, and platelets (P < 0.0001).
Conclusions:
- Splenectomy, with careful perioperative management, is beneficial for SCD patients.
- It reduces transfusion needs, alleviates discomfort from enlarged spleens, prevents ASSC, and manages splenic abscess.