Giugno 2000 - Volume XIX - numero 6

Medico e Bambino

Problemi non correnti

Indicazioni alla splenectomia


Clinica Pediatrica, Centro di Emato-Oncologia, IRCCS “Burlo Garofolo”, Trieste


Key words: Splenectomy, Haemolytic anemias, Immunisation

Progress in surgical techniques and in management and understanding of haematologic diseases stimulate a critical reappraisal of splenectomy. Spleen plays an important role in removing normal and abnormal cells from the blood and in providing immunologic response to encapsulated bacteria. Surgical splenectomy provides effective treatment for several paediatric disorders, such as congenital and acquired haemolytic anemias, abdominal traumas, immunologic and metabolic disorders, but it is associated with immediate risk of morbidity and life-long risk of overwhelming infection. Alternatives to conventional splenectomy include laparoscopic splenectomy, partial splenectomy, partial splenic embolisation and autologous splenic transplantation. Recommendations for the prevention of overwhelming postsplenectomy infection include pneumococcal, H. influentiae type b and meningococcal immunisations, antimicrobial prophylaxis and prompt antibiotic treatment of acute febrile illness. Asplenic patients should be also advised on the increased risk of severe falciparum malaria and susceptibility to babesiosis and infection by C. canimorsum. Finally, prophylaxis for thrombotic risk is recommended in selected cases.

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P. Tamaro, E. Barth Indicazioni alla splenectomia. Medico e Bambino 2000;19(6):373-375

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