Elective Splenectomy for Haemolytic Anaemia: A Case Series

Abstract

The spleen plays an important role in immune surveillance and haematopoiesis. Elective splenectomy is sometimes indicated for excessive cellular destruction (hypersplenism) or sequestration, lymphomatous or myeloid disease, or tumours. Hereditary haemolytic anaemias are disorders with a variety of causes, including red cell membrane defects, red blood cell enzyme disorders, congenital dyserythropoietic anaemias, thalassaemia syndromes, and haemoglobinopathies. Splenectomy is one of the therapeutic approaches in the management of haematological conditions. This is case series of 12 cases who underwent elective splenectomies for haemolytic anaemias in a tertiary care centre, over a period of one year. Out of the 12 patients, 10 patients were diagnosed to have Hereditary Spherocytosis (HS) and 2 patients were diagnosed with sickle cell anaemia. For all patients, preoperative blood transfusion was done to bring the Haemoglobin (Hb) above 9 g/dL for elective splenectomy. Among the 10 patients with HS, 6 patients had concomitant cholelithiasis for which cholecystectomy was done in the same sitting and three patients developed postoperative complication which was managed appropriately with no mortality and minimum morbidity. However, more detailed studies on this subset of patients are needed for the establishment of guidelines and optimal outcomes.

Keywords

• blood transfusion
• cholelithiasis
• massive splenomegaly
• spleen