Visceral leishmaniasis (VL), also known as Kala-azar, is a systemic infection caused by a protozoan (Leishmania) and, in its classic form, is a serious illness associated with malnutrition, anemia, hepatosplenomegaly, infectious processes and coagulopathies. The effect of splenectomy in patients with visceral leishmaniasis is not well defined; however, it is known that the spleen is the largest reservoir of infected cells belonging to the reticulo endothelial system. Therefore, the surgical procedure is an option for the debulking of parasites, providing a cure for refractory VL and minimizing the complications of hypersplenism.Keywords: Splenectomy. Leishmaniasis. Hypersplenism. RESUMOA leishmaniose visceral (LV) ou calazar é uma infecção sistêmica causada por um protozoário (Leishmania) e na sua forma clássica é uma doença grave. Cursa com desnutrição, anemia, hepatoesplenomegalia, processos infecciosos e coagulopatias. O papel da esplenectomia em pacientes com leishmaniose visceral não é bem definido; entretanto, sabe-se que o baço é o maior reservatório de células parasitadas do sistema reticulo endotelial e o procedimento cirúrgico é, dessa forma, uma opção para debulking de parasitas, propiciando a cura da LV refratária e minimizando as complicações do hiperesplenismo.Palavras-chaves: Esplenectomia. Leishmaniose. Hiperesplenismo.Visceral leishmaniasis (VL), also known as Kala-azar, is a systemic infection caused by a protozoan of the family Trypanosomatidae, genus Leishmania, which has two forms: a flagellated form or promastigote, found in the digestive tract of the insect vector, and a nonflagellated form or amastigote, which is an obligate intracellular form that is found in the cells of the mononuclear phagocytic system of the vertebrate host. The primary vector is Lutzomyia, for which the dog is the reservoir and humans are the final host. Visceral leishmaniasis is one of the six most important endemic diseases in the world, given its incidence and high mortality rates in untreated individuals, malnourished children and HIV-positive individuals. The disease exists in all continents except Australia and Antarctica 1 . Visceral leishmaniasis has been documented in all regions of Brazil except the southern region. The disease occurs in rural and urban areas of Cities such as Rio de Janeiro/RJ, Belo Horizonte/ MG, Araçatuba/SP, and Corumbá/MS. Currently in Brazil, VL is registered in 19 of 27 states 2 . The classic symptoms consist of fever, sweating, adynamia, hepatosplenomegaly, malnutrition, cough, diarrhea, abdominal pain and distention, edema and ascites 3 . The diagnosis is based on the presence of the parasite in the bone marrow, spleen, liver, or lymph nodes. Several tests have been developed for the serologic diagnosis of VL, including molecular biology techniques 4 . Meglumine antimoniate remains the first-choice drug for treatment, and amphotericin B is the second-line drug used in cases of meglumine antimoniate resistance 5,6 . The effect of splenectomy on VL is unknown. The importance...

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