SPLENECTOMY IN A GENERAL-HOSPITAL

Splenectomy is often performed in patients with malignant disease or t rauma who are at a high risk of complications. In the long term, it in creases the risk of infection by encapsulated bacteria. An audit was p erformed to determine the reasons for splenectomy in a district genera l hospital, to review the results and complications of surgery, and to see how often the patients were prescribed antibacterial prophylaxis, Twenty-eight patients underwent splenectomy in 3 years. The indicatio n was haematological disease in 13 and trauma in four. In the remainin g nine the spleen was removed either as part of a radical gastrectomy or during some other abdominal procedure, Six of the 28 patients had d ied, one within 30 days from disseminated intravascular coagulopathy f ollowing an emergency gastrectomy and splenectomy for haematemesis, tw o from progressive haematological malignant disease, two from nonhaema tological malignancy, and one from bronchopneumonia. Of the nine patie nts (32%) with complications, three required a further laparotomy, Mos t patients had been prescribed pneumococcal vaccine (85%) and prophyla ctic antibiotics (93%).