• Journal of Veterinary Clinics
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• v.33 no.4
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• pp.214-217
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• 2016

A 10-year-old, 24.1 kg, intact female Siberian husky dog (case 1) and 11-year-old, 5.0 kg, intact male Shihtzu dog (case 2) presented with chief complaints of polydipsia, anorexia, vomiting and exercise intolerance (case 1) and stranguria (case 2). Splenic nodule (case 1) and mass (case 2) were identified in these patients through ultrasonographic examination. Laparoscopic splenectomy was conducted for the histopathologic evaluation. In addition, laparoscopic ovariohysterectomy, liver biopsy (case 1) and castration (case 2) were performed for treatment or diagnosis of primary symptoms. Under general anesthesia, 5 mm three-portal access laparoscopic splenectomy was performed using the Sonicision$^{TM}$ equipment. The dogs were rotated onto right lateral recumbency. The spleen was elevated using a fan or goldfinger retractor, which revealed the ventral aspect of the spleen. Resection of vessels was started at the caudal aspect of the spleen using the Sonicision$^{TM}$. The excised spleen was removed from the abdominal cavity using a 12 mm endo-bag via the enlarged instrument portal. There were no post-operative complications in either patient. Histopathologic diagnoses were splenic lymphoid hyperplasia (case 1) and splenic nodular hyperplasia (case 2). Based on our experience, laparoscopic splenectomy is sufficient to replace traditional splenectomy in small animal surgery. The use of the Sonicision$^{TM}$ could be a novel surgical technique for three-portal laparoscopic splenectomy, regardless of patient size.

• Advances in pediatric surgery
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• v.10 no.1
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• pp.31-34
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• 2004

The laparoscopic splenectomy (LS) became popular over the last 10 years. The advantage of LS over open splenectomy (OS) includes short hospital stay, improved cosmesis, less development of postoperative intestinal ileus, and less analgesics required. The purpose of this study is to evaluate the outcome of LS at Asan Medical Center from January 1999 to January 2003. The records of 14 consequent children who underwent splenectomy were reviewed retrospectively. Patients characteristics, morbidity, mortality, operative time, blood loss, and hospital stay were analyzed., Seven patients age 5 to 15 years underwent LS under the indications: idiopathic thrombocytic purpura (ITP, n=3), hereditary spherocytosis (n=3), and myelodysplastic syndrome (n=l). Seven patients, age 7 to 16 years, underwent OS during the same period for ITP (n=7). Median operative time was 120 mInutes (80 to 170 mins.) in OS, and 270 minutes (110 to 480 mins,) in LS (p<0.05). Median length of hospital stay was 6 days (3 to 8) in OS, and 4 days (3 to 6) in LS (p>0.05). Median splenic length was 12.0cm (9.2 to 18.0) in OS, 14.0 cm (10.0 to 19.5) (p>0.05). Accessory spleens were identified in 3 of 7 LS and 1 of 7 OS cases. In the LS group, there was no conversion to open surgery. Two patients in LS required blood transfusion postoperatively. LS in children can be performed as effectively and safely as OS.

• Korean Journal of Veterinary Research
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• v.33 no.2
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• pp.327-336
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• 1993

Present experiments were undertaken in order to clarify the effect of splenectomy on the hematology and marrow megakaryocyte picture and to know the genesis of postsplenectomy thrombocytosis in dogs. Six mongrel dogs weighing 8.5~18㎏ were used, of which three were splenectomized and the other three were laparotomized for comparison. Erythrocyte count, total and differential leukocyte counts, thrombocyte count and packed cell volume measurement were made using the blood samples. In addition, bone marrow samples obtained from the femur at 7th and 23rd day of the operation were examined for the number per low-power field, the diameter, and the distribution frequency of the megakaryocyte. From these experiments, following results were obtained : Erythrocyte count and packed cell volume showed significant decrease beginning on the 15th day of splenectomy. Total and differential leukocyte counts showed marked increase for the first 2 days of postsplenectomy. The thrombocyte count of splenectomized dogs increased from the 2nd day of the operation, reached to the peak count on the 15th day, and returned to the preoperation count by the 28th day. The megakaryocyte count per low-power field of the biopsied preparation increased in according to the increase in thrombocyte count. The megakaryocyte diameter of splenectomized dog showed no increase on the 7th or 23rd day of the operation. However, the distribution frequency of the larger megakaryocyte was higher in the splenectomized dogs than in the laparotomized dogs. The total plasma protein concentration showed no significant change after splenectomy or laparotomy. From these results, it may be concluded that the postsplenectomy thrombocytosis results from the increased megakaryocytopoesis or the activated thrombocytopoesis of the marrow megakaryocytes.

• Journal of Trauma and Injury
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• v.35 no.3
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• pp.189-194
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• 2022

Purpose: The purpose of this study was to determine whether a higher Injury Severity Score (ISS) could serve as an indicator of splenectomy in patients with traumatic splenic lacerations. Methods: A total of 256 cases of splenic laceration were collected from January 1, 2005 to December 31, 2018. After the application of exclusion criteria, 105 were eligible for this study. Charts were reviewed for demographic characteristics, initial vital signs upon presentation to the emergency room, Glasgow Coma Scale, computed tomography findings, ISS, and treatment strategies. The cases were then divided into nonsplenectomy and splenectomy groups for analysis. Results: When analyzed with the chi-square test and t-test, splenectomy was associated with a systolic blood pressure lower than 90 mmHg, a Glasgow Coma Scale score lower than 13, active bleeding found on computed tomography, a splenic laceration grade greater than or equal to 4, and an ISS greater than 15 at presentation. However, in multivariate logistic regression analysis, only active bleeding on computed tomography showed a statistically significant relationship (P=0.014). Conclusions: Although ISS failed to show a statistically significant independent relationship with splenectomy, it may still play a supplementary role in traumatic splenic injury management.

• Korean Journal of Animal Reproduction
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• v.19 no.2
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• pp.141-145
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• 1995

The effect of splenectomy on the concentration of progesterone in pregnant wistar rats showing 4-day regular estrous cycles more than two cycles were investigated. The day after mating with the same male animal was designated day 0 of pregnancy. Splenectomy was conducted on day 0 (early-S), 6 (middle-S) and 13 (late-S) of pregnant rat, respectively. Blood sample were collected at day 1, 7, 14 and 21 of pregnancy. Concentraton of serum progesterone was determined by emzyme-linked immunosorbent assay (ELISA) using specific antibodies and emzyme conjugate(progesterone peroxidase labeled). In normal pregnant rats, serum progesterone concentrations were increased significantly (P<0.05) on day 7 and 14 of pregnancy compared with on day 1 of pregnancy and then dramatically decreased on day 21. However in early and middle splenectomized rats, progesterone concentrations were significantly (P<0.05) decreased on day 7 and 14 of pregnancy compared with same day of normal rats. These observations indicate that luteotropic action and steroidogenesis by corpus luteum of ovary may be regulated by splenocytes in rat.

• Advances in pediatric surgery
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• v.12 no.1
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• pp.32-40
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• 2006

Four children with solid and papillary epithelial neoplasm of the pancreas are reported. Three were girls. Mean age at operation was 12 years and 7 months (10-13 years). Clinical presentation included nausea, vomiting, and apalpable mass. One had hemoperitoneum due to tumor rupture. In two cases, tumors were in the body of the pancreas, and one the body and tail, and in one,the tail. Mean diameter of the tumors was 10.8 cm (8-15cm). Surgical procedures were distal pancreatectomy and splenectomy in 2 cases, distal pancreatectomy in one, and subtotal pancreatectomy and splenectomy in one. Mean follow-up period was 61 months (6-121 months). Three patients are still alive without any recurrence. However, in the one case of ruptured tumor, portal vein thrombosis and liver metastasis developed after subtotal pancreatectomy and splenectomy during the course of postoperative adjuvant chemotherapy.

• Advances in pediatric surgery
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• v.12 no.2
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• pp.244-250
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• 2006

Splenic abscess is a rare clinical condition with a reported incidence of 0.14 % to 0.70 % in various autopsy series. Primary tuberculosis of the spleen as a cause of splenic abscess is even rarer, especially in the antitubercular era. Infants and children have a higher predisposition to extra-pulmonary tuberculosis than adults and tend to develop severe extra-pulmonary disease such as miliary tuberculosis and meningitis. The diagnosis of tuberculosis in infants and children can be difficult because of nonspecific symptoms and clinical findings. Computed tomography establishes the diagnosis of splenic abscess and demonstrates the number and location of abscesses. Splenectomy is the standard of care in most clinical setting. We present a 4-year-old girl who had multiple tuberculosis splenic abscesses and was treated successfully with splenectomy.

• Journal of Trauma and Injury
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• v.31 no.2
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• pp.87-90
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• 2018

Non-operative management has been preferred in blunt spleen injury. Moreover children are more susceptible to post-splenectomy infection, spleen should be preserved if possible. However, splenectomy is inevitable to patients with severe splenic injury. Therefore splenic autotransplantation could be the last chance for preserving splenic function in these patients although efficacy has not proven. Here we reported four cases of children who were underwent splenic autotransplantation successfully after blunt trauma.

• Parasites, Hosts and Diseases
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• v.23 no.1
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• pp.156-164
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• 1985

To elucidate the effect of splenectomy on the development of experimental primary amoebic meningoencephalitis in mice, the death rate and survival time of mice infected intranasally with Naegleria fowleri trophozoites $5{\times}10^4$ cultivated in CGVS medium were compared according to the mouse age when splenectomy was done, and post-operation until experimental infection. Immunodigusion was undergone to detect the presence of serum antibod). due to N, fowleri infecttion in mice. Polyacrylamide gel electrophoresis was done to compare the protein fractions of mouse serum in each experimental groups. In experiment I, splenectomy was done 3 weeks and infection 4 weeks after birth, the death rate of control, sham operated and splenectomized group were 100%, 85% and 95%, and the mean survival time after infection 7.3 days, 7.5 days and 7.8 days, respectively. In experiment II, splenectomy was undergone 3 weeks and infection 6 weeks after birth, the death rate of of control, sham operated and splenectomized group were 95%, 95% and 95%, and the mean survival time after infection 12.1 days, 11.5 days and 11.5 days, respectively. In experiment III, splenectomy was done 5 weeks and infection 6 weeks after birth, the death rate of control, sham operated and splenectomized group were 95%, 90% and 95%, and the mean survival time after infection 8.1 days, 8.3 days and 8.5 days, respectively. By Ouchterlony immunodigusion, anti-JV. fowleri antibody in the serum of mouse with primary amoebic meningoencephalitis was detected against a N. fowleri antigen, which was prepared by ultrasonication of N, fowleri trophozoites, each reacting two lines of precipitation. The patterns of serum fractions by polyacrylamide gel electrophoresis were different between control and sham operated groups from splenectomized group in fraction II, III and V, the sera of which were collected after N. fowleri infection. This results may be summarized as that splenectomy has no effect on the development of primary amoebic meningoencephalitis in mice.

• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.42-48
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• 1994

Among the erythrocyte membrane defects, hereditary spherocytosis is the most common. The erythrocyte membrane defect results from a deficiency of spectrin, the most important structural protein in red cell. Hereditary spherocytosis often presents with hemolytic anemia, jaundice, moderate splenomegaly. Diagnosis is established by the presence of spherocytes in the peripheral blood, reticulocytosis, an increased osmotic fragility, and a negative Coombs test. In children, splenectomy is usually performed after age 6 years but can be done at a younger age if warranted by the severity of the anemia and the need for frequent transfusions. In the period December 1987 to Agust 1993, 9 patients with hereditary spherocytosis underwent splenectomy and the following results were obtained. 1. Nine patients were comprised of five males and four females. 2. Five patients(55.6%) had been admitted to our hospital during age 6-10 years. 3. Four of the nine patients had autosomal dominant inheritance with variable expression. The other five patients had no known inheritance. 4. The diagnosis of the spherocytosis was based on the increased osmotic fragility and increased autohemolysis of the erythrocytes, as well as on the appearance of spherocytes in the peripheral blood smear. 5. In all cases splenectomy was performed. Two patients had concomitant gall stones and choledocholithiasis, respectively. One patient with concomitant gall stones underwent simultaneous cholecystectomy and splenectomy. The other patient associated with choledocholithiasis underwent splenectomy, cholecystectomy, choledocholithotomy, and T-tube drainage. 6. Complete hematologic recovery was obtained by the splenectomy in all cases. 7. Postoperative complication was not occurred.