Forty-seven patients who underwent splenectomy for splenomegaly > or = 1000 g were studied retrospectively. There were 29 men and 18 women of mean age 56 (range 19-87) years. Haematological malignancy was the most common disorder (42 patients). The main indications for splenectomy were cytopenia (20 patients), diagnosis (14), initial treatment of leukaemia (eight), pain (four) and spontaneous rupture (one). Thirteen patients underwent an associated surgical procedure. One patient died (mortality rate 2 per cent) and 12 (26 per cent) had postoperative complications. The advantages of splenectomy included histopathological diagnosis in 13 of 14 patients with splenomegaly of unknown origin, effective initial treatment in prolymphocytic and hairy cell leukaemia, definitive relief of pain in all affected patients, and long-term improvement of cytopenia in most.

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Lumbar hernias, namely transiliac hernias, are not frequent events and are almost always associated with bone graft harvesting from the iliac crest. We describe a case of transiliac hernia 10 years after bone graft harvest, the patient presenting with right colon incarceration. Diagnosis was made by CT scan. The hernia was repaired with a composite polypropylene-PTFE mesh (Bard(®)).

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