Role of Splenectomy in Homozygous Sickle Cell Disease in Childhood

Indications and complications of splenectomy for children with sickle cell disease

“…Lack of readily available blood in our setting and poor compliance of parents make repeat blood transfusion an unsuitable form of therapy. We, like others, advocate splenectomy if the child develops 2 minor attacks [15]. This is to obviate a recurrence risk of 40% to 50% and a mortality rate as high as 20% [8,13].…”

Sonographic Assessment of Spleen Size in Saudi Patients with Sickle Cell Disease

“…It can effectively be treated with blood transfusions, but has a propensity to recur with several episodes in a short period of time, and surgical splenectomy is frequently required in the long-term management of such patients. 6,20,[22][23][24] Recurrence of acute splenic sequestration becomes less likely after the age of five years, and the tendency to spontaneous splenic atrophy in SCD has favored a conservative approach. This, however, is not the case in our patients.…”

The Role of Splenectomy in Patients with Sickle Cell Disease

“…25 Whereas the criteria for splenectomy in minor attacks of ASSC are not clear, we agree with others that splenectomy should be considered after two such attacks. 18,26 This is especially so in situations like ours, where blood transfusions are not readily available and poor compliance of the parents makes chronic blood transfusion an unsuitable form of treatment. Patients with SCD tend to develop splenic hypofunction as part of the natural course of their disease.…”

“…for those over six years of age. The duration of prophylactic antibiotics remains controversial, 26,54,55 but since infection is most likely to occur within two to three years of surgery, most people recommend giving it for at least two to three years postsplenectomy. [50][51][52][53] …”