When the splenic injury, even the trivial injury, was occured, splenectomy has been considered a choice of treatment. Recently the fact has been clarified that OPSI (overwheliming postsplenectomy infection) was occured in children as well as adult after splenectomy. So, the efforts directed toward the splenic preservation such as nonoperative management, methods using hemostatic agents, repair and closure of splenic capsule, partial splenectomy, autotransplantation and reimplantation.
The author selected 14 weeks old, weighing 280±3gm, 107 rats as experimental animal.
The standardized splenic trauma was performed in each rat´s spleen with specific designed equipment and also performed wedge resection following various surgical procedures, postoperatively, all rats were observed for mortality during 1 week.
RBC , WBC, platelet, Hb, and Hct, were obtained on postoperative 1,2,3,4,6, and 8weeks and then observed relationship to retained amount of the splenic tissue.
Postoperatively 4 weeks, each rat was challenged with 3 xl08 /ml of Escherichia coli intraperitoneally, and rats were observed for mortality during 1 week.
The results were as following;
1) Following the splenic trauma, even though-no repair was attemped, most cases were appeared spontaneous hemostasis and mortality was 22%.
2) Following the splenic trauma, if the adequate operative procedures including repair, hemisplenectomy, primary closure were performed, the mortality due to bleeding was none.
3) The microscopic findings following splenorrhaphy were demonstrated the normal splenic architecture.
4) After each rat was challenged with 3x108 /ml organisms of Escherichia coli intraperitoneally, the mortality was 80% in total splenectomy, 30% in hemisplenectomy, 10% in no repair cases, 0% in splenic tissue normally preserved cases. So the incidence of sepsis was proportioned to amount of the preserved splenic tissue.
5) In the case of which the splenic tissue was retained normally by repair and primary closure, increased WBC and platelet values returned to preoperative levels within 4 weeks, within 6 or 8 weeks for the hemisplenectomy, whereas the values for the total splenectomy were still abnormally increased state after 8 weeks. So the increased and decreased values of WBC and platelet were proportioned to the amount of preserved splenic tissue.
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