Splenectomy in sickle cell disease.

ABSTRACT

INTRODUCTION: Since role of splenectomy in sickle cell disease still remains controversial, this paper evaluates the same in 32 cases of splenectomy in sickle disease patients observed by the author. MATERIAL AND METHODS: After proper diagnosis by standard methods the cases were observed for 2-3 years before deciding on splenectomy. Though acute splenic sequestration (53%) and chronic hypersplenism (21.8%) were the main indication. Two cases of splenic abscess and one case with frequent pain attacks were also subjected to splenectomy. There was one immediate post-operative death. RESULTS: The cases were followed up for 1 to > 8 years. While Acute splenic sequestration disappeared, in chronic hypersplenism cases as well as others besides a sense of general well being, steady state hemoglobin rose by > 2G/dl in 81% and significant increase in height and weight was seen in 90% and 61% cases respectively. Frequency of pain attack, fever, anaemia and need for blood transfusion improved in 79% patients. CONCLUSION: Splenectomy in selected cases appears to be an acceptable procedure in sickle disease.