Between 1956 and 1981, 306 splenectomies for hematologic diseases were performed at the UCLA Medical Center. Of these operations, more than 75% were performed for therapeutic reasons to control anemia, thrombocytopenia, neutropenia, or painful symptoms of splenomegaly. Of the 65 patients who had idiopathic thrombocytopenic purpura, 77% showed an excellent response, and of the 39 patients who had hereditary spherocytosis, 90% responded. Other diseases with predictably good response rates were autoimmune hemolytic anemias, Felty's syndrome, and hairy cell leukemia. Forty patients with Hodgkin's disease had splenectomies for diagnostic purposes the last 10 years. The overall morbidity and mortality were 24% and 6%, respectively, the most common complications being pneumonia, wound infections, and local postoperative bleeding, and the most common cause of death being sepsis. The review supports the thesis that in carefully selected patients, therapeutic splenectomy can have desirable palliative effects and that diagnostic splenectomy has a sufficiently low risk to warrant its consideration in patients with Hodgkin's disease.

Adolescent↗

PubMed1981

Calcified left ventricular thrombus causing repeated retinal arterial emboli: clinical, echocardiographic, and pathologic features.

The clinical, echocardiographic, and pathologic features of a discrete calcified left ventricular thrombus are presented in a young adult man with a two-year history of transient visual field defects leading to eventual loss of vision in his left eye. M-mode and cross-sectional echocardiographic studies suggested a large mass extending across the left ventricle. These findings were confirmed at surgery when a calcified mass pathologically consistent with a calcified thrombus was removed. The pertinent literature on the echocardiographic diagnosis of left ventricular thrombi is reviewed.

Adult↗