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Subtotal splenectomy for treatment of splenomegalic growth and sexual hypodevelopments

BACKGROUND: According to the literature, splenic dwarfism is an immune disease due to the splenic presence and its treatment is total splenectomy. Following a line research related to subtotal splenectomy, the aim of this study was to verify whether a conservative procedure on the spleen by preserving the upper splenic pole vascularized only by the splenogastrics vessels is an adequate procedure to treat splenic dwarfism. METHOD: Four male teenagers (14, 14, 16 and 17 years old) with splenomegaly (3 due to schistosomiasis and other due to auto-immune cirrhosis) presented growth and sexual hypodevelopment and were submited to subtotal splenectomy. Surgical indications were oesophageal and gastric variceal haemorrhages and pancytopenia. RESULTS: The four boys increased their growth reaching in one year adequate somatic and sexual development. CONCLUSION: We conclude that dwarfism is not due to the presence of the spleen, but rather due to splenomegaly and subtotal splenectomy should be considered for the treatment of splenomegalic growth and sexual hypodevelopment.

Splenectomy; Subtotal splenectomy; Portal hypertension; Splenomegaly; Dwarfism; Schistosmiasis


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