Laparoscopic accessory splenectomy for recurrent idiopathic thrombocytopenic purpura

Yong U. Choi, Edward P. Dominguez, Vadim Sherman, John F. Sweeney

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Background: Splenectomy has 50% to 70% long-term efficacy for immune thrombocytopenic purpura (ITP). In some patients, relapse is due to the presence of residual accessory splenic tissue. Methods: A 44-year-old male had ITP since 1983 with splenectomy in 1985. He had a transient response, but then developed severe thrombocytopenia refractory to multiple modalities for 20 years. An accessory spleen was first visualized in 2000. Results: A laparoscopic accessory splenectomy was performed without difficulty. The patient had an initial response with a significant increase in platelet count. Although over time the thrombocytopenia recurred, there has been a long-term benefit in that the patient is on much lower doses of prednisone to maintain an adequate platelet count. Conclusion: The finding of accessory splenic tissue after prior splenectomy may be an increasingly common problem in patients with recurrent ITP. Although reported response rates for resection of residual splenic tissue vary, the availability of a safe, less morbid, minimally invasive approach makes the decision to operate easier.

Original languageEnglish (US)
Pages (from-to)314-317
Number of pages4
JournalJournal of the Society of Laparoendoscopic Surgeons
Volume12
Issue number3
StatePublished - Dec 1 2008

Keywords

  • ITP (immune thrombocytopenia)
  • Laparoscopic surgery
  • Splenectomy
  • Thrombocytopenia

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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