Post-splenectomy subphrenic infection: the value of closed suction drainage system

ABSTRACT

This series was carried out for 90 patients underwent splenectomy [60 splenectomy only + 30 splenectomy with oesophago-gastric devascularization]. They were 76 males and 14 females and their age was ranging from 13 to 45 years. The patients were divided into three groups each one included 20 patients performing splenectomy and 10 patients operated upon for splenectomy and devascularization. The splenic bed was drained in the first group by closed suction drainage system, in the second group by corrugated drain and in the third group, the abdomen was closed without drain. The development of subphrenic abscess was diagnosed by X-ray [plain and screening], ultrasonography, as well as clinically [temperature, pain, toxaemia] and by leucocytic count. The incidence of subphrenic abscess was correlated to the type of drainage, its duration and the type of operation. It was observed that the usage of closed suction drain for short duration [2 days], had the value to decrease the incidence of subphrenic infection. The suction drain allows the egress of blood and serous fluid from the splenic bed with minimal chance of ingress of bacteria in comparison to ordinary corrugated drain. The usage of closed suction drainage system provides the most reliable and acceptable means of splenic bed drainage