Abstract
From 1969-1978, 456 splenectomies in children 0-15 yrs old were registered in Denmark. The underlying disease in 56% was traumatic splenic rupture, in 20% hereditary spherocytosis, in 13% idiopathic thrombocytopenic purpura and in 11% various other disease; 384 (84%) were followed retrospectively for a mean period of 6.2 yrs after splenectomy. Twenty-one (5.5%) contracted bacteremia or meningitis, in 15 (71%) caused by Streptococcus pneumoniae, and 6 (1.6%) died from the infection. The frequency of postsplenectomy infection (PSI) was lower in children with splenic rupture (2.5%) than in those with hereditary spherocytosis (4.9%), idiopathic thrombocytopenic purpura (11.5%) and Hodgkin''s disease (13.8%); 16% of children splenectomized before the age of 4 yrs vs. 4% above that age developed PSI. Of the PSI cases, 95% occurred < 6 yrs after splenectomy. The incidence of severe pneumococcal bacteremia and pneumococcal meningitis in the splenectomized was 284 times that of non-splenectomized children.