Operations for Splenic Trauma

Abstract

Following splenectomy for trauma, children experience fatal sepsis at a rate 58 to 65 times greater than that experienced by the nonsplenectomized child. Sudden in onset, the sepsis is often fatal within 24 hours despite good medical treatment. It is generally caused by the encapsulated pneumococcus, meningococcus, Haemophilus. or sometimes Escherichia coli. Although the cases of fatal sepsis appear to be somewhat more common when a splenectomy is performed in a child under the age of 5 years, and although the fatal sepsis is likely to occur within 2 years of the splenectomy, there are many reports of fatal sepsis due to meningitis, pneumonia, and other causes, sometimes occurring many years after splenectomy. While it is difficult to determine exactly how much increase there is in the risk of fatal sepsis following splenectomy for trauma in the adult, there is general agreement that there is indeed some increase in this risk (Leonard, Giebink, Baesl et al.; Schwartz, Sterioff, Mucha et al.; Singer).