The splenectomy is an important therapeutic measure in idiopathic thrombocytopenic
purpura, especially in adult chronic form, because the spleen is the major site of the
production of platelet antibody and the destruction of the platelets.
Fifteen adult patients who underwent splenectomy for idiopathic thrombocytopenic
purpura between January 1970 and January 1984, were evaluated.
The results obtained were as follows:
1. Age distribution was between 14 and 49 years (mean; 2i.5 years), and male to
female ratio was 1 : 2.8.
2. Chief complaints on admission were purpura, epistaxis, gum bleeding, uterine
bleeding, hematuria and persistent bleeding after tooth extraction, in order.
3. Duration of disease from onset to splenectomy was between 1 month and 7 years
(mean ; 22 months).
4. The platelet count on admission was between 4,500/㎣ and 91,000/㎣ (mean; 35,000/
㎣),
5. The indication for splenectomy were no response to corticosteriod in 8 and partial
response to corticosteriod in 7.
6. Nine (60%) had complete remissions and none had sub sequently relapsed. The
other six who failed to achieve remission were treated with corticosteroid and/or
immunosuppressive agents. Two of them had complete remissions and 3 good response.
But 1 had been refractory to all treatments.
7. Accessory spleens were removed during splenectomy in 2. There was no mortality
associated with splenectomy. Subphrenic abscess was complicated in 3 after
splenectomy.
8. When the duration of disease from onset to splenectomy is short and the platelet
counts (immediately after splenectomy and/or maximal increase during postoperative
period) is high, the response to splenectomy were relatively good, but there was no
statistical significance (p>0.05).
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