Abstract
BACKGROUND: The spleen was considered by Galen as organ of mystery, by Aristotle as unnecessary, by Pliny as an organ that might hinder the speed of runners and also as an organ that produced laughter and mirth, a notion reaffirmed in the Babylonian Talmud. Splenectomy as a therapeutic modality is widely used in management of hematological disorders. Splenectomy is specifically indicated for children with Thalassemia, Hereditary spherocytosis and Chronic Idiopathic thrombocytopenic purpura refractory to medical treatment considering its advantages of being an effective procedure. AIMS AND OBJECTIVES: The objectives of the present study was to determine various indications, age and sex incidence for splenectomies in hematological diseases and to study the histopathological changes of the splenectomy specimens in detail. MATERIAL AND METHODS: The present retrospective study was undertaken at Department of Pathology, Paediatric Referral Hospital. We reviewed 17 specimens that were received over a span of 5 years. Routine hematological, biochemical, serological laboratory investigations and bone marrow aspirates were evaluated. The splenectomy specimens were examined after routine processing and staining with Haematoxylin and Eosin. RESULTS: The most common indication for splenectomy was Thalassemia (41.1%). Splenectomy was commonly done in the age group 18 months - 12 years. The incidence of splenectomy was 1.8 times more common in boys than in girls. Histopathological picture of spleen in various lesions was consistent with the changes secondary to the disease. CONCLUSION: Thalassemia proved to be the most common indication for splenectomy in paediatric age group followed by hereditary spherocytosis and refractory Idiopathic thrombocytopenic purpura. Splenectomy has been the safest and most effective procedure for children with Chronic or Refractory Idiopathic thrombocytopenic purpura. Rarely splenectomy has shown to be beneficial in patients with lymphoma, Kasabach-Merritt syndrome and Gaucher's disease.
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