Pediatric Surgery International

, Volume 26, Issue 5, pp 495–500

Clinical events after surgical splenectomy in children with sickle cell anemia

  • Ram Kalpatthi
  • Ian D. Kane
  • Ibrahim F. Shatat
  • Betsy Rackoff
  • Deborah Disco
  • Sherron M. Jackson
Original Article

DOI: 10.1007/s00383-010-2587-4

Cite this article as:
Kalpatthi, R., Kane, I.D., Shatat, I.F. et al. Pediatr Surg Int (2010) 26: 495. doi:10.1007/s00383-010-2587-4

Abstract

Purpose

Despite advances in immune prophylaxis, sepsis remains the most feared complication following splenectomy for acute splenic sequestration crisis (ASSC) in children with sickle cell anemia (SCA). We seek to investigate the true prevalence of sepsis and other complications of splenectomy in this patient population.

Methods

We reviewed the records of children with SCA (HbSS) who underwent splenectomy for ASSC between 1993 and 2008 at a single institution.

Results

Fifty-eight patients (33 males) at a median age of 2 years at splenectomy were included with an average post-splenectomy follow-up of 6.4 years (range 6 months–14 years). Thirty-seven patients (64%) underwent laparoscopic splenectomy, and acute chest syndrome (ACS) was the most common post-operative complication (6.9%). There was no difference in the incidence of sepsis pre- and post-splenectomy. The occurrence of vaso-occlusive pain crises (VOC) and ACS was significantly higher after splenectomy. In addition, 14 patients (24%) developed stroke (n = 5) or an abnormal transcranial Doppler (TCD) (n = 9) after splenectomy.

Conclusion

Our data suggest that splenectomy can be safely performed in children with SCA given a low risk of sepsis. However, the increased incidence of VOC, ACS, and stroke or abnormal TCDs after splenectomy remains a concern.

Keywords

Splenectomy Children Transcranial Doppler Sepsis Stroke 

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Ram Kalpatthi
    • 1
  • Ian D. Kane
    • 2
  • Ibrahim F. Shatat
    • 2
  • Betsy Rackoff
    • 2
  • Deborah Disco
    • 2
  • Sherron M. Jackson
    • 2
  1. 1.Division of Pediatric Hematology and OncologyThe Children’s Mercy Hospitals and ClinicsKansas CityUSA
  2. 2.Department of PediatricsMedical University of South CarolinaCharlestonUSA

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