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Revista Colombiana de Cirugía
Print version ISSN 2011-7582On-line version ISSN 2619-6107
Abstract
RAMOS-PENAFIEL, Christian Omar; GALLARDO-RODRIGUEZ, Adán Germán; MARTINEZ-TOVAR, Adolfo and MARTINEZ-MURILLO, Carlos. Main modifications associated with splenectomy. rev. colomb. cir. [online]. 2023, vol.38, n.3, pp.512-520. Epub Apr 25, 2023. ISSN 2011-7582. https://doi.org/10.30944/20117582.2292.
Introduction.
The spleen is a lymphoid organ involved in antigen recognition, pathogen clearance, and removal of aged erythrocytes or those with cytoplasmic inclusions. Splenectomy is a technique used for diagnosis (lymphomas), treatment (immune thrombocytopenia, acquired hemolytic anemia), and cure (hereditary microspherocytosis) of various diseases.
Methods.
To describe the main hematological changes and complications associated with the splenectomy procedure.
Discussion.
Changes after splenectomy can be considered immediate: the appearance of Howell-Jolly bodies, thrombocytosis, and leukocytosis during the first two weeks. Other complications include the presence of thrombosis, especially in patients with risk factors (age, sedentary lifestyle, long hospital stay, obesity) or a hypercoagulable state (diabetes, cancer, primary thrombophilia), with both portal vein flow and splenic volume being the main risk factors for its appearance. Late complications include altered immune response, increased risk of infections by encapsulated bacteria, and a reduction in IgM levels secondary to the absence of B lymphocytes in the spleen; due to the risk of diseases mainly by Streptococcus pneumoniae, partial splenectomy has been considered an option.
Conclusion.
An adequate assessment of the indication for splenectomy and the early identification of complications are essential to reduce the mortality associated with splenectomy.
Keywords : splenectomy; splenic diseases; postoperative complications; thrombosis; leukocytosis; Howell-Jolly bodies.