Splenectomy and sepsis

Splenectomy and sepsis.

hro su tho French an T ughout the ages, the function of the spleen was bject to much conjecture. It was variously ught to be both the centre of melancholy by the d the centre for anger by the English (“to vent one’s spleen”). Of no doubt was that if the spleen was ruptured, survival was unlikely. Modern surgery has allowed the survival of patients with a ruptured spleen, usually following traum...

Splenectomy Protects against Sepsis Lethality

Splenectomy and the incidence of venous thromboembolism and sepsis in patients with immune thrombocytopenia.

Patients with immune thrombocytopenia (ITP) who relapse after an initial trial of corticosteroid treatment present a therapeutic challenge. Current guidelines recommend consideration of splenectomy, despite the known risks associated with surgery and the postsplenectomy state. To better define these risks, we identified a cohort of 9976 patients with ITP, 1762 of whom underwent splenectomy. The...

Splenectomy inactivates the cholinergic antiinflammatory pathway during lethal endotoxemia and polymicrobial sepsis

The innate immune system protects against infection and tissue injury through the specialized organs of the reticuloendothelial system, including the lungs, liver, and spleen. The central nervous system regulates innate immune responses via the vagus nerve, a mechanism termed the cholinergic antiinflammatory pathway. Vagus nerve stimulation inhibits proinflammatory cytokine production by signal...

Leukocytosis after posttraumatic splenectomy: a physiologic event or sign of sepsis?

HYPOTHESIS Although elevations in white blood cell count (WBC) and platelet count (PC) after splenectomy for trauma constitute a physiologic event, certain WBC and PC patterns help differentiate patients with from those without sepsis. DESIGN Medical record and trauma registry record retrospective review. SETTING Academic level I trauma center. PATIENTS From February 1997 through May 2001...