BACKGROUND: Splenic complications of sickle-cell disease (SCD) are ass
ociated with morbidity, and in some it may lead to mortality. This pap
er presents our experience with 43 patients with SCD who had splenecto
my as part of their management. PATIENTS AND METHODS: The records of 4
3 patients with SCD who had splenectomy were examined for age at opera
tion, sex, hemoglobin (Hb) electrophoresis, indication for splenectomy
, pre- and postoperative medications, operative procedures, and postop
erative complications. RESULTS: The indications for splenectomy were a
cute splenic sequestration crisis (ASSC) in 21 patients, hypersplenism
in 15, and splenic abscess in 7. In 17 patients, the spleen was also
found to be massively enlarged causing discomfort and intervening with
everyday activity. For those with hypersplenism, there was a signific
ant postoperative increase in total Hb (P <0.0001), hematocrit (P <0.0
001), white blood cells (P <0.0001), and platelet count (P <0.0001). C
ONCLUSIONS: With careful perioperative management and proper follow-up
, splenectomy in patients with SCD is beneficial in reducing their tra
nsfusion requirements and its attendant risks, eliminating the discomf
ort from mechanical pressure of the enlarged spleen, avoiding the risk
s of ASSC, and managing splenic abscess.