RESULTS OF SPLENECTOMY PERFORMED ON A GROUP OF 91 CHILDREN

In the period 1971-1990 91 children underwent splenectomies in the Uni versity Hospital of Nijmegen. The most important indications are hered itary spherocytosis, Hodgkin's disease and very severe immune thromboc ytopenic purpura (ITP). Splenectomy after a traumatic rupture of the s pleen has become less frequent: hom 20 % in 1971-1980 to 4 % in 1981-1 990. Short-term complications included thrombocytosis (84 %), fever wi thout an obvious cause (46 %), which is quite regularly seen in patien ts suffering from Hodgkin's disease (48 %), and infections of the resp iratory tract in 10 % of the patients. The platelet count shows a stea dy increase in the first nine post-operative days. No thromboembolic c omplications were seen. Based upon the Literature there seems to be no reason at this moment for anti-platelet aggregation therapy when plat elet counts are below 1000x10(9)/l. More information about long-term c omplications was obtained through a questionnaire completed by general practitioners. The morbidity through overwhelming post splenectomy in fection (OPSI) is 3.8 % (3/79), the mortality of OPSI is 2.5 % (2/79). Underlying diseases, especially those which involve the immunological system as auto immune haemolytic anemia (AIHA), seem to play an impor tant role in the possible development of OPSI (morbidity 2/11, 18 %).