Trauma is a public health problem and the most common cause of death in people under the age of 45. In blunt abdominal trauma, the spleen is the most commonly injured organ. Splenectomy remains the most common treatment, especially in high-grade lesions, despite increased nonoperative treatment. Removal of the spleen leads to increased susceptibility to infections due to its role in the immune function. Postsplenectomy sepsis is an important complication and presents a high mortality rate. Patients undergoing splenectomy should be immunized for encapsulated germs, as these are the agents most commonly associated with such infections. Splenic autotransplantation is a simple procedure, which can be an alternative to reduce infection rates consequent to total splenectomy, and reduce costs related to hospitalizations. This review aims to provide evidence-based information on splenic autotransplantation and its impact on the prognosis of patients undergoing total splenectomy. We searched the Cochrane Library, Medline/PubMed, SciELO and Embase, from January 2017 to January 2018 and selected articles in English and Portuguese, dated from 1919 to 2017. We found that the adjusted risk of death in splenectomized patients is greater than that of the general population, and when total splenectomy is performed, splenic autotransplantation is the only method capable of preserving splenic function, avoiding infections, especially postsplenectomy sepsis. Health professionals should be familiar with the consequences of the method chosen to manage the patient suffering from splenic trauma.

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Acta Med Port 2014 Jul-Aug;27(4):511-514 RESUMOUma das complicações conhecidas da litíase vesicular consiste na perfuração da vesícula com consequente formação de abcessos colecisto-cutâneos ou trajectos fistulosos externos. Actualmente este tipo de complicação é pouco frequente na prática diária, tendo sido mais frequente. Os autores relatam o caso de uma senhora de 86 anos, acamada e dependente, referenciada à nossa instituição por apresentar uma tumefacção no quadrante superior direito, com sinais inflamatórios associados. A investigação imagiológica da referida tumefacção revelou tratar-se de um abcesso subcutâneo associado a perfuração da vesicula biliar, cuja análise histológica revelou colecistite xantogranulomatosa. Palavras-chave: Abcesso; Colecistite; Granuloma; Xantomatose; Tecido Subcutâneo. ABSTRACTOne of the known complications of gallstones consists in gallbladder perforation with cholecystocutaneous abscesses or external fistulas formation. Nowadays these types of complications are uncommon, having been more frequent. The authors report the case of an 86 year-old woman, bedridden and dependent, referred to our institution by presenting a tumefaction with inflammatory signs in the right upper quadrant. The radiological investigation revealed it to be a subcutaneous abscess associated with a perforated gallbladder, whose histological analysis revealed xanthogranulomatous cholecystitis.