Circulatory control of splenic hyperfunction in children with peripheral blood dyscrasia

C. L. Witte, J. J. Corrigan, M. H. Witte, D. B. Van Wyck, R. E. O'Mara, J. M. Woolfenden

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Ligation of the splenic artery was performed upon six children with a variety of peripheral cytopenias associated with hypersplenism to decrease splenic hyperfunction while preserving some splenic tissue. While this procedure initially improved the peripheral blood values in five patients - two patients with hereditary spherocytosis, one patient with idiopathic thrombocytopenic purpura, one patient with pyruvate-kinase hemolytic anemia and one patient with posthepatic cirrhosis and splenomegaly - the hematologic derangement gradually recurred in four, necessitating eventual splenectomy in two. The sixth patient, an infant with histiocytosis-x, died soon after ligation of the splenic artery. Scintiscans of the spleen corroborated regrowth of the splenic remnant, principally the lower pole to which the vascular supply in the splenocolic ligament was not interrupted. Although ligation of the splenic artery is safe and promptly reduces splenic overactivity, this operation can only be viewed as temporizing and not as definitive treatment of hypersplenism. On the other hand, in view of the protective function of the spleen against certain bacteria and protozoa, particularly in children with blood dyscrasia, the idea of achieving eusplenism or mild hyposplenism rather than asplenism by a graded reduction in the functional splenic mass through ischemic treatment of hypersplenism seems sound. Alternative methods of circulatory control, for instance, embolization of the splenic artery, of splenic function should be cautiously pursued.

Original languageEnglish (US)
Pages (from-to)75-80
Number of pages6
JournalSurgery Gynecology and Obstetrics
Volume150
Issue number1
StatePublished - 1980

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology

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