Indications for splenectomy in a tertiary care hospital in South India

Abstract

Background: Splenectomy is a surgical treatment for a wide range of diseases including symptomatic splenomegaly, autoimmune, malignant, hereditary and congenital disorders, splenic injury/rupture secondary to blunt trauma to abdomen. By far the two most common atraumatic indications for splenectomy are malignancy and haematological autoimmune disorders, such as Idiopathic Thrombocytopenic Purpura (ITP) and Autoimmune Hemolytic Anemia (AIHA). Methods: We did a retrospective study in a tertiary care hospital, of all patients undergoing splenectomy over a 5-year period to describe the indications for splenectomy. Results: 186 patients under went splenectomy, both emergency and elective (Open or Laparoscopic – conventional and hand-assisted). Most common indication was hematological in 153 patients, of which ITP-70 (37.6%) was the highest. Non-hematological indications were secondary to splenic cyst or abscess, neuroendocrine tumour of the pancreas, hydatid cyst of spleen. Emergency splenectomy was done for blunt trauma to abdomen, and grade 5 injury was commonly encountered. Among all, 16 (8.6%) patients had spleniculi. Conclusion: In patients with hematological disorders, splenectomy must be undertaken only after anticipating both, short- and long-term risks and potential benefits to the patient.