Intraoperativne i postoperativne komplikacije splenektomije

Abstract

Spleen is being surgically removed because of trauma, in diagnostic and-or therapeutical purposes because of the benignant and malignant diseases. The percentage of morbidity during and after splenectomy is relatively low. During surgery might occur bleeding, trauma of the pancreatic tail, stomach, lineal flexure of the colon, left hemidiafragm, left suprarenal gland and upper pole of the left kidney, which must be correspondingly reclaimed during the same intervention. In the early postoperative period, postoperative bleeding, subfrenic abscess, pulmonal atelectasis, bronchopneumonia and left pleural extravasations might occur. Especially is important notification of these events in due time and adequate conservative and surgical treatment. After splenectomy, there is an increase of the number of trombocytes, which might lead to the tromboembolic complications. In the prevention of these complications in the postoperative period prolonged antiagregation therapy is suggested. Postsplenectomy sepsis is very late, general complication of splenectomy, which occurs because of the lower immunity in the child age. To prevent these complications, partial splenectomies, reimplantations of the spleen, prolonged application of the penicillin medicines after splenectomy and antipneumococcal vaccine are performed.

Growth of the lower spleen pole remaining after subtotal splenectomy in rats

“…Complete removal of the spleen can cause local and systemic complications, 1 the most serious being fulminant sepsis, which has been reported in five children with spherocytosis submitted to total splenectomy. 2 Infectious complications after removal of the spleen have also been observed in experimental animals.…”

O pólo inferior do baço de ratos e a oxigenoterapia hiperbárica

“…A esplenectomia total pode provocar complicações no transoperatório e no pós-operatório 1 . Dessas, a mais preocupante é a infecção fulminante que foi relatada por King e Schumaker Jr 2 e foi recentemente revista 3 .…”

Pediatric Splenic Injury: Nonoperative Management First!

“…OPSI has an estimated incidence of 0.23-0.42% per year, with a lifetime risk of 5% [15,16]. The risk of developing OPSI is much higher for children (4%) compared to adults (1%), and mortality varies between 38 and 69% [17,18]. Splenectomy performed for haematological disorders carried a higher reported incidence of and mortality from OPSI than splenectomy undertaken for trauma [17].…”

“…The risk of developing OPSI is much higher for children (4%) compared to adults (1%), and mortality varies between 38 and 69% [17,18]. Splenectomy performed for haematological disorders carried a higher reported incidence of and mortality from OPSI than splenectomy undertaken for trauma [17]. Underlying diseases, especially those which involve the immunological system as auto immune haemolytic anemia (AIHA), seem to play an important additional role in the possible development of OPSI [19].…”