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October 24, 1980

Dangers of Splenectomy

JAMA. 1980;244(17):1899. doi:10.1001/jama.1980.03310170013005

To the Editor.—  Juan F. Jaramillo, MD, and Leroy C. Barry, MD (243:1656, 1980), advocated repair for the traumatic spleen in agnogenic myeloid metaplasia because of the operative and some postoperative complications. However, they did not mention the real risk of grave and often fatal course of certain blood born infections, especially pneumococcemia, in patients who have undergone splenectomies. This risk apparently persists for the entire lifetime of the patients.1 The preventive and prophylactic measures, such as immunization, autotransplantation, and long-term penicillin therapy, are under investigation, although these measures also have some inherent difficulties, such as patient compliance. It has been recently reported2 that a patient who has undergone splenectomy and who discontinued prophylactic penicillin therapy for only two weeks died of pneumococcemia. Burrington3 has reported successful repair of ruptured spleens in eight cases.In my opinion every spleen that has sustained traumatic injury deserves a serious