Splenectomy for Hematologic Disorders

Abstract

In 1887, Sir Spencer Wells [1] operated on a patient with the preoperative diagnosis of a uterine fibroid, but instead he noted a “wandering spleen”, which he removed. The patient later proved to have hereditary spherocytosis; thus, the first surgical cure of a hematologic disorder was inadvertent and became manifest postoperatively when the patient’s anemia and chronic jaundice disappeared. Micheli is generally given credit for introducing the concept of splenectomy for hemolytic anemia in an article published in 1911 [2]. As a medical student in Prague, Kaznelson proposed to Schloffer, a professor of surgery, that splenectomy for idiopathic thrombocytopenic purpura be performed in a 36-year-old woman. The case and the successful elevation of the platelet count to above normal levels was reported 4 weeks after the procedure in 1916 [3].