소아의 비장적출술

Abstract

In Korea, studies of splenectomies are mainly performed in adult groups, but a review of splenectomies in children is significant because the indications of a splenectomy and the importance of the spleen in children are different from those in adults. The authors reviewed 51 cases of splenectomies performed between January 1986 and April 1996 on children under 15 years of age. The indications of the splenectomy were divided based on hematologic diseases (37)and non-hematologic diseases (14). For the hematologic diseases, hereditary spherocytosis (24) was the most common indication of a splenectomy and idiopathic thrombocytopenic purpura (11) was the next most common. For non-hematologic diseases, trauma (10) was the most common indication of a splenectomy. After the splenectomy, abnormal hematologic findings were improved in all hereditary spherocytosis patients and in nine of the idiopathic thrombocytopenic purpura patients (82%).To prevent postsplenectomy sepsis, 27 patients received antibiotic medication, but no one received a pneumococcal vaccination. One case of post-splenectomy sepsis occurred in a patient who had not received antibiotic medication. This study suggests that a splenectomy provides efficacious treatment for a number of pediatric disorders, but it is associated with a risk of postsplenectomy sepsis.