Trauma is a public health problem and the most common cause of death in people under the age of 45. In blunt abdominal trauma, the spleen is the most commonly injured organ. Splenectomy remains the most common treatment, especially in high-grade lesions, despite increased nonoperative treatment. Removal of the spleen leads to increased susceptibility to infections due to its role in the immune function. Postsplenectomy sepsis is an important complication and presents a high mortality rate. Patients undergoing splenectomy should be immunized for encapsulated germs, as these are the agents most commonly associated with such infections. Splenic autotransplantation is a simple procedure, which can be an alternative to reduce infection rates consequent to total splenectomy, and reduce costs related to hospitalizations. This review aims to provide evidence-based information on splenic autotransplantation and its impact on the prognosis of patients undergoing total splenectomy. We searched the Cochrane Library, Medline/PubMed, SciELO and Embase, from January 2017 to January 2018 and selected articles in English and Portuguese, dated from 1919 to 2017. We found that the adjusted risk of death in splenectomized patients is greater than that of the general population, and when total splenectomy is performed, splenic autotransplantation is the only method capable of preserving splenic function, avoiding infections, especially postsplenectomy sepsis. Health professionals should be familiar with the consequences of the method chosen to manage the patient suffering from splenic trauma.

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Recebido em 4/3/99 Aceito para publicação em 17/11/99 Trabalho realizado no Serviço de Cirurgia Geral do Hospital Geral de Fortaleza. DISCUSSÃO Cisto do mesentério foi primeiramente descrito em 1507 (apud Liew) pelo anatomista Benevienae. A primeira excisão foi realizada por Tillaux (apud Chung) somente em 1880 2. Apesar do longo tempo do reconhecimento desta enfermidade, sua origem, classificação e patologia permanecem controversas. A maior incidência encontrase entre a terceira e quarta décadas de vida, sendo 75% dos casos diagnosticados após os 10 anos de idade 2,3 , com discreto predomínio do sexo feminino 1 .