Mohammad Shahzad Arshed, Shamim Qureshi, Asghar Channa, Mumtaz Maher


Objective: Splenectomy is often performed in patients with heamatalogical diseases or trauma
who are at high risk of complications. Our aim is to perform an audit on splenectomy in order
to determine the reasons for the operation, its complication and compliance with the recent
recommendations for post-splenectomy patients at Jinnah Postgraduate Medical Centre.
Design: It is a Descriptive study conducted in surgical ward 2 at Jinnah Postgraduate Medical
Centre from June 2003 to June 2008. Methods: A retrospective review of hospital records of
surgical ward 2 of consecutive splenectomy patients with a mean follow up of 12 months.
Results: Fifty-five patients underwent splenectomy in 6 years duration. The mean age was 26.7
years. The indication for splenectomy was mainly heamatological diseases and trauma.
Vaccination was done in 83.6% patients. Twelve patients had postsplenectomy complications,
although there were no cases of OPSI. Mean hospital stay was 6.4 days. Conclusion: We still
lack compliance with the standard guidelines for post-splenectomy patients. There is space for
an improvement of the vaccination rate and prophylactic antibiotic. Patients should be
counselled for the risk of OPSI and should have a splenectomised card for prompt treatment.
There is need for careful documentation of this important health risk and counselling of patients
in the discharge summaries.
Keywords: splenectomy, pneumococcal, vaccination, antibiotic, prophylaxis

Full Text:



Aster JC. Diseases of white blood cells, lymph nodes, spleen and

thymus. In: Kumar V, Abbas AK, Fausto M. (Eds) Robbins and

Cotran Pathologic basis of disease. Elsevier Saunders,

Philadelphia, 7th Ed. 2005:p661–709.

Tiron A, Vasilescu C. Role of the spleen in immunity.

Immunologic consequences of splenectomy. Chirurgia (Bucur)


Plinius Secundus. The history of the world. (Phileman Holland,

transl). London: Islip;1634.

Wells, TS. Remarks on splenectomy with a report of a successful

case. Med Chir Trans 1888;71:255–63.

Martin Jugenburgabc, Graham Haddockabc, Melvin

H Freedmanabc, Lee Ford-Jonesabc, Sigmund H Ei. The

morbidity and mortality of pediatric splenectomy: does

prophylaxis make a difference? J Pediatr Surg 1999;34(7):1064–7.

Lynch AM, Kapila R. Overwhelming post splenectomy

infection. Infect Dis Clin North Am 1996;10:693–707.

Zarrabi MH, Rosner F. Rarity of failure of penicillin prophylaxis

to prevent post splenectomy sepsis. Arch Intern Med


Bolan G, Broome CV, Facklam RR, Plikayatis BD, Fraser DW,

Schlech W. Pneumococcal vaccine efficacy in selected

populations in the United States. Ann Intern Med 1986;104:1–6.

Murdoch IA, Dos Anjos R. Continued need for pneumococcal

prophylaxis after splenectomy. Arch Dis Child 1990;65:1268–9.

Wilhelm MC, Jones RE, McGehee R, Mitchener JS, Sandusky

WR, Hess CE. Splenectomy in hematologic disorders. The everchanging indications. Ann Surg 1988;207(5):581–9.

Glatstein E, Guernsey JM, Rosenberg SA, Kaplan HS. The value

of laparotomy and splenectomy in the staging of Hodgkin’s

disease. Cancer 1969;24:709–18.

Sandusky WR, Jones RCW Jr, Horsley JS III, Marsh WL

Jr, Tillack TW, Tegtmeyer CJ, et al. Staging laparotomy in

Hodgkin's disease. Ann Surg 1978;187:485–9.

Goffinet DR, Warnke R, Dunnick NR, Castellino R, Glatstein

E, Nelsen TS, et al. Clinical and surgical(laparotomy) evaluation

of patients with non-Hodgkin's lymphomas. Cancer Treat Rep


Chabner BA, Johnson RE, DeVita VT, Canellos GP, Hubbard

SP, Johnson SK, et al. Sequential nonsurgical and surgical

staging of non-Hodgkin's lymphoma. Cancer 1978;42:922–5.

Hess CE. Approach to patients with lymphadenopathy or

splenomegaly.In Thorup OA Jr, ed. Fundamentals of Clinical

Hematology. Philadelphia: WB Saunders;1987. p.536–77.

Working Party of the British Committee for Standards in

Haematology Clinical Haematology Task Force. Updated

guideline: the prevention and treatment of infection in patients

with an absent or dysfunctional spleen. eBMJ 2001.

Brigden ML, Pattullo A, Brown G. Pneumococcal vaccine

administration associated with splenectomy: the need for

improved education, documentation, and the use of a practical

checklist. Am J Hematol 2000;65:25–9.

Ejstrud P, Hansen JB, Andreasen DA. Prophylaxis against

pneumococcal infection after splenectomy: a challenge for

hospitals and primary care. Eur J Surg 1997;163:733–8.

Glass JM, Gilbert JM. Splenectomy in general hospital. J R Soc

Med 1996;89:199–201.

Jockovich M, Mendenhall NP, Sompeck MD, Talllbert JL,

Copeland EM, et al. Long term complications of laparatomy in

Hodgkin’s disease. Ann Surg 1994;219:615–24.

Musser G, Lazar G, Hocking W, Bussutil RW. Splenectomy for

haemotologic disease. The UCLA experience with 306 patients.

Ann Surg 1984:200–4.

Adelusola K A, Osasan SA, Afolabi OA. Histopathological study

and audit of the spleen in Nigerians Afr J of Health Sci



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