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February 1985

Splenectomy: In and Out of Fashion

Author Affiliations

Veterans Administration Medical Center Washington, DC 20422

Arch Intern Med. 1985;145(2):225-227. doi:10.1001/archinte.1985.00360020045004

Robert Frost declared, some years ago, that truth keeps going in and out of fashion. Splenectomy rides such a pendulum. It was at first a risky operation, performed because of splenomegaly, often on patients who were gravely ill. But when Micheli and Kaznelson1 showed that extirpation of the spleen could cure hemolysis and thrombocytopenia in patients nearly dead of their disease, the operation flourished, first in Europe, later spreading to America.

In 1923 from Mayo Clinic Giffin and Holloway2 described a case of thrombocytopenic purpura, a failure of "expectant" therapy:

The patient came to the Clinic January 9,1922, complaining of weakness. For the last four months she had noticed numerous petechiae on her arms and legs and body. For three months the menses had been almost continuous. At times there would be oozing only; again the flow would be so profuse that she would have to go to