Splenectomy

The indications for splenectomy are now well established and include massive splenomegaly, recurrent splenic infarctions, hypersplenism requiring frequent blood transfusions, severe thrombocytopenia, and portal hypertension. Perioperative bleeding, infection, and thrombosis result in a surgery-related mortality of approximately 10 percent and a surgery-related morbidity rate of over 30 percent.34 Compensatory hepatic myeloid metaplasia, leading to rapid hepatic enlargement, is a well-recognized complication, as is an enhanced leukemic transformation rate. The importance of the commonly associated coagulopathy should not be underestimated, with 15 percent of patients exhibiting laboratory evidence of disseminated intravascular coagulation.

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