The avoidable complications of splenectomy

Operative injury to the spleen and consequent accidental splenectomy is neither an infrequent nor an inconsequential occurrence. It still accounts for 25 per cent of all splenectomies performed. The morbidity rate resulting from this accident is well above 50 per cent, and the mortality may be as high as 15 per cent. Appreciation of the peritoneal anatomy of the spleen with prophylactic division of the splenoperitoneal folds will lessen the incidence of capsular avulsion injuries. When capsular avulsion injuries do occur, they may be effectively treated with topical hemostatic agents, such as microfibrillar collagen, Avitene. Twenty-one instances in which splenectomy for capsular avulsion injury was averted have been reported. In the last 15 of these, the topical hemostatic agent used was Avitene.