Splenic Studies

King, Harold; Shumacker, Harris B.

doi:10.1097/00000658-195208000-00006

Cited by 831 publications

(36 citation statements)

References 2 publications

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“…When a splenectomy is unavoidable, patients are at an increased risk of developing an overwhelming postsplenectomy infection (OPSI). The description of this syndrome in 1952 led to a management shift toward preservation of splenic function in patients suffering blunt splenic injury (BSI) 4,5. The annual risk of developing an OPSI in asplenic adult patients is 0.18%–0.42% and the lifetime risk of these patients is ~5% 6,7.…”

Section: Introductionmentioning

confidence: 99%

A cohort study to evaluate infection prevention protocol in pediatric trauma patients with blunt splenic injury in a Dutch level 1 trauma center

Spijkerman¹,

Teuben²,

Hietbrink³

et al. 2018

PPA

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PurposeAsplenic patients are at increased risk for the development of overwhelming postsplenectomy infection (OPSI) syndrome. It is believed that adequate immunization, antimicrobial prophylaxis, as well as appropriate education concerning risks on severe infection lead to the decreased incidence of OPSI. The aim of this study was to analyze the methods used to prevent OPSI in trauma patients splenectomized before the age of 18.Patients and methodsA retrospective, single-center study of all pediatric patients sustaining blunt splenic injury (BSI) managed at our level 1 trauma center from January 1979 to March 2012 was performed. A questionnaire was sent to all the included patients to determine the level of knowledge concerning infection risks, the use of antibiotics, and compliance to vaccination recommendations. Furthermore, we investigated whether the implementation of guidelines in 2003 and 2011 resulted in higher vaccination rates.ResultsWe included 116 children with BSI. A total of 93 completed interviews were eligible for analysis, resulting in a total response rate of 80% and 1,116 patient years. Twenty-seven patients were splenectomized, and 66 patients were treated by a spleen preserving therapy (including embolization). Only two out of 27 splenectomized patients were adequately vaccinated, five patients without a spleen used prophylactic antibiotics, and about half of the asplenic patients had adequate knowledge of the risk that asplenia entails. A total of 22/27 splenectomized patients were neither adequately vaccinated nor received prophylactic antibiotics. There was no OPSI seen in our study population during the 1,116 follow-up years.ConclusionThe vaccination status, the level of knowledge concerning prevention of an OPSI, and the use of prophylactic antibiotics are suboptimal in pediatric patients treated for BSI. Therefore, we created a new follow-up treatment guideline to have adequate preventive coverage to current standards for these patients.

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Section: Introductionmentioning

confidence: 99%

A cohort study to evaluate infection prevention protocol in pediatric trauma patients with blunt splenic injury in a Dutch level 1 trauma center

Spijkerman¹,

Teuben²,

Hietbrink³

et al. 2018

PPA

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“…The first description of OPSI was published by King and Schumaker in 1952 [15]. The disease may begin as a minor flu like illness that rapidly escalates into a fulminant infection.…”

Section: Opsimentioning

confidence: 99%

Overwhelming Postsplenectomy Infection for Splenectomized HCV Patients

Hashimoto¹

2015

OALib

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Pegylated-interferon (IFN) plus ribavirin remains the most effective therapeutic regimen for patients with chronic hepatitis C interferon. Thrombocytopenia is a common side effect of this treatment, often leading to discontinuation of a potentially curative therapy. Splenectomy was a clinically effective treatment for hepatitis C virus-associated thrombocytopenia. Splenectomy in patients with hepatitis C cirrhosis is now safer prelude to antiviral treatment. Overwhelming post splenectomy infection (OPSI) syndrome is a rare condition, but is associated with high mortality. However, recognition and clinical management of OPSI is not well established. We reviewed the literature characterizing the clinicopathological features of OPSI and assessed the most effective and feasible administration of the condition. Prevention strategies such as vaccination and education are also potentially important parts of the strategy for splenectomized HCV patients.

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“…Nos animais dos grupos operados 2,3,4 , a seqüência operatória foi a seguinte: indução anestésica com vapores de éter etílico; depilação das paredes abdominal e torácica ventral; anti-sepsia das paredes abdominal e torácica ventral com álcool iodado, e colocação de um campo operatório para delimitar o local da laparotomia; incisão longitudinal, mediana, da pele e subcutâneo, com cerca de 2,5 cm de comprimento, iniciada 0,5 cm abaixo do processo xifóide em direção ao púbis; abertura da linha alba e peritônio; e exame da cavidade abdominal.…”

Section: Métodosunclassified

“…Dessas, a mais temida é a infecção pós-esplenectomia 2,3 . As complicações infecciosas após a retirada do baço foram também descritas em animais de experimentação 4,5 .…”

Section: Introductionunclassified

Lípides plasmáticos em ratos após cirurgia esplênica - efeito de dois tipos de dieta

Paulo¹,

Paulo²,

Kalil³

et al. 2007

Rev. Assoc. Med. Bras.

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A esplenectomia total pode induzir complicações locais e sistêmicas 1 . Dessas, a mais temida é a infecção pós-esplenectomia 2,3 . As complicações infecciosas após a retirada do baço foram também descritas em animais de experimentação 4,5 . Além dessas complicações, têm sido relatadas, após esplenectomia, alterações no metabolismo lipídico, tanto em seres humanos 6-8 quanto em animais de experimentação [9][10][11][12][13] . Por essas razões, têm sido cada vez mais valorizadas as operações conservadoras sobre o baço. Nesse contexto, incluem-se as ligaduras vasculares. A ligadura da artéria esplênica é realizada como coadjuvante do tratamento do trauma esplênico 14,15 CONCLUSÃO. A esplenectomia total provoca aumento do colesterol total, da LDL-colesterol, da VLDL-colesterol e dos triglicérides, que é mais significante nos animais alimentados com a dieta acrescida de colesterol. A ligadura simultânea da artéria e da veia esplênicas previne contra as alterações dos níveis de lípides plasmáticos observadas em ratos submetidos à esplenectomia total e mantém esses níveis similares aos dos grupos controle e simulação.UNITERMOS: Baço / metabolismo. Esplenectomia / efeitos adversos. Esplenectomia / métodos. Ligadura da artéria esplênica. Ligadura da veia esplênica.quando associada à infusão de solução salina e comparada à esplenectomia 22 . Em cães, a ligadura de ramos da artéria esplênica contribui para a indução de pancreatite crônica 23, mas protege o animal de infecção por pneumococo, quando associada à exérese do pólo inferior do baço 24. A ligadura da artéria esplênica em coelhos diminui a resposta imune à administração intravenosa de antígenos morfologicamente modelados 25 . A ligadura simultânea da artéria e da veia esplênicas, com preservação do baço, em seres humanos, foi realizada na pancreatectomia caudal por laparatomia 26,27 e por via laparoscópica 28 . As conseqüências para o baço dessa ligadura simultânea foram recentemente descritas 29 . Não se sabe o efeito dessa ligadura nem de diferentes dietas sobre os níveis de lípides plasmáticos, em ratos. Por essas razões, planejamos estudar os efeitos da ligadura simultânea da artéria e veia esplênicas e da esplenectomia total sobre os níveis de lípides plasmáticos de ratos adultos, alimentados com dieta controle ou com dieta acrescida de 2,5% de colesterol.

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Splenic Studies

Cited by 831 publications

References 2 publications

A cohort study to evaluate infection prevention protocol in pediatric trauma patients with blunt splenic injury in a Dutch level 1 trauma center

A cohort study to evaluate infection prevention protocol in pediatric trauma patients with blunt splenic injury in a Dutch level 1 trauma center

Overwhelming Postsplenectomy Infection for Splenectomized HCV Patients

Lípides plasmáticos em ratos após cirurgia esplênica - efeito de dois tipos de dieta

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