Indications for splenectomy in a general hospital

Background. To analyse the evolution of indications for splenectomy for a I i-year period. Methods. A review was made of cases of splenectomy from clinical records an d the records of the Pathology Service at Hospital General Universitario Gr egorio Maranon from 1986 to 1996. Both adult and pediatric cases were inclu ded. Results. From 1986 to 1996 there was a total of 354 patients (273 males and 162 females) who underwent splenectomy. Mean age of patients was 44.6 year s (SD +/- 20.5 years) and there was an average of 39.5 cases per year. The most common causes were trauma (32%), "incidental" splenectomy (14%), throm bopenia (12%) and non Hodgkin lymphoma (11%). Compared with the other cause s, the mean age of patients with trauma was lower than that of the other gr oups (p < 0.0001), in contrast with patients with non Hodgkin lymphoma or e xtra-splenic tumors, where it was higher (p < 0.0001 for both groups). A de cline was observed of cases due to trauma from the first to the last year o f the study (p = 0.0009), as well as an increase in the group of splenectom y related to extrasplenic tumors (p = 0.01). In the group of the HIV infect ed patients (n = 30), thrombopenia was the most common indication for splen ectomy (11 cases). Conclusions. Although the average of splenectomy cases remains relatively c onstant, a decrease in cases due to trauma was observed and an increase of splenectomies on account of abdominal oncologic resections.