Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Approach to the adult with splenomegaly and other splenic disorders

Stanley L Schrier, MD
Section Editor
William C Mentzer, MD
Deputy Editor
Jennifer S Tirnauer, MD


The spleen is a hematopoietic organ capable of supporting elements of the erythroid, myeloid, megakaryocytic, lymphoid, and monocyte-macrophage (ie, reticuloendothelial) systems [1]. As such, it is important in the following situations:

The spleen participates in cellular and humoral immunity through its lymphoid elements. (See "The adaptive cellular immune response" and "The humoral immune response".)

The spleen is involved with the removal of senescent red blood cells, bacteria, and other particulates from the circulation through elements of the monocyte-macrophage system. An increase in this function (ie, hypersplenism) may be associated with varying degrees of cytopenia, while removal of the spleen (ie, asplenia) may render the patient susceptible to bacterial sepsis, especially with encapsulated organisms [2]. (See "Extracorpuscular non-immune hemolytic anemia: Fragmentation hemolysis and hypersplenism", section on 'Extravascular nonimmune hemolysis due to hypersplenism' and "Clinical features and management of sepsis in the asplenic patient" and "Prevention of sepsis in the asplenic patient".)

Splenectomy in patients with various hematologic disorders (eg, thalassemia, stomatocytosis) has been associated with an increased incidence of vascular complications, including venous and arterial thrombosis and pulmonary hypertension [2,3].

Normally, approximately one-third of circulating platelets are sequestered in the spleen, where they are in equilibrium with circulating platelets.

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Sep 2017. | This topic last updated: Oct 16, 2017.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
  1. Wilkins BS. The spleen. Br J Haematol 2002; 117:265.
  2. Rodeghiero F, Ruggeri M. Short- and long-term risks of splenectomy for benign haematological disorders: should we revisit the indications? Br J Haematol 2012; 158:16.
  3. Crary SE, Buchanan GR. Vascular complications after splenectomy for hematologic disorders. Blood 2009; 114:2861.
  4. Gielchinsky Y, Elstein D, Hadas-Halpern I, et al. Is there a correlation between degree of splenomegaly, symptoms and hypersplenism? A study of 218 patients with Gaucher disease. Br J Haematol 1999; 106:812.
  5. Buffet PA, Milon G, Brousse V, et al. Ex vivo perfusion of human spleens maintains clearing and processing functions. Blood 2006; 107:3745.
  6. Logan A, Berube C, Gotlib J. Accessory splenules in autoimmune hemolytic anemia. Am J Hematol 2013; 88:156.
  7. Mazur EM, Field WW, Cahow CE, et al. Idiopathic thrombocytopenic purpura occurring in a subject previously splenectomized for traumatic splenic rupture. Role of splenosis in the pathogenesis of thrombocytopenia. Am J Med 1978; 65:843.
  8. Bernaudin F, Socie G, Kuentz M, et al. Long-term results of related myeloablative stem-cell transplantation to cure sickle cell disease. Blood 2007; 110:2749.
  9. Pearson HA, Cornelius EA, Schwartz AD, et al. Transfusion-reversible functional asplenia in young children with sickle-cell anemia. N Engl J Med 1970; 283:334.
  10. Wethers DL, Grover R. Reversibility of splenic function by transfusion in two young adults with sickle cell anemia. Am J Pediatr Hematol Oncol 1987; 9:209.
  11. Aster RH. Pooling of platelets in the spleen: role in the pathogenesis of "hypersplenic" thrombocytopenia. J Clin Invest 1966; 45:645.
  12. Bolze A, Mahlaoui N, Byun M, et al. Ribosomal protein SA haploinsufficiency in humans with isolated congenital asplenia. Science 2013; 340:976.
  13. Santos A, Pinheiro V, Anjos C, et al. Scintigraphic follow-up of the effects of therapy with hydroxyurea on splenic function in patients with sickle cell disease. Eur J Nucl Med Mol Imaging 2002; 29:536.
  14. Powsner RA, Simms RW, Chudnovsky A, et al. Scintigraphic functional hyposplenism in amyloidosis. J Nucl Med 1998; 39:221.
  15. Yücel AE, Durak H, Bernay I, et al. Functional asplenia and portal hypertension in a patient with primary splenic hemangiosarcoma. Clin Nucl Med 1990; 15:324.
  16. Fishman D, Isenberg DA. Splenic involvement in rheumatic diseases. Semin Arthritis Rheum 1997; 27:141.
  17. Piliero P, Furie R. Functional asplenia in systemic lupus erythematosus. Semin Arthritis Rheum 1990; 20:185.
  18. Muller AF, Cornford E, Toghill PJ. Splenic function in inflammatory bowel disease: assessment by differential interference microscopy and splenic ultrasound. Q J Med 1993; 86:333.
  19. Di Sabatino A, Carsetti R, Corazza GR. Post-splenectomy and hyposplenic states. Lancet 2011; 378:86.
  20. Rogers ZR, Wang WC, Luo Z, et al. Biomarkers of splenic function in infants with sickle cell anemia: baseline data from the BABY HUG Trial. Blood 2011; 117:2614.
  21. Lammers AJ, de Porto AP, Bennink RJ, et al. Hyposplenism: comparison of different methods for determining splenic function. Am J Hematol 2012; 87:484.
  22. Prendki V, Ndour PA, Jais X, et al. Reduced deformability of circulating erythrocytes: a marker of hyposplenism. Am J Hematol 2012; 87:E81.
  23. Harrod VL, Howard TA, Zimmerman SA, et al. Quantitative analysis of Howell-Jolly bodies in children with sickle cell disease. Exp Hematol 2007; 35:179.
  24. Corazza GR, Ginaldi L, Zoli G, et al. Howell-Jolly body counting as a measure of splenic function. A reassessment. Clin Lab Haematol 1990; 12:269.
  25. Corazza GR, Tarozzi C, Vaira D, et al. Return of splenic function after splenectomy: how much tissue is needed? Br Med J (Clin Res Ed) 1984; 289:861.
  26. Pearson HA, Johnston D, Smith KA, Touloukian RJ. The born-again spleen. Return of splenic function after splenectomy for trauma. N Engl J Med 1978; 298:1389.
  27. Normand JP, Rioux M, Dumont M, et al. Thoracic splenosis after blunt trauma: frequency and imaging findings. AJR Am J Roentgenol 1993; 161:739.
  28. Nielsen JL, Ellegaard J, Marqversen J, Hansen HH. Detection of splenosis and ectopic spleens with 99mTc-labelled heat damaged autologous erythrocytes in 90 splenectomized patients. Scand J Haematol 1981; 27:51.
  29. Livingston CD, Levine BA, Lecklitner ML, Sirinek KR. Incidence and function of residual splenic tissue following splenectomy for trauma in adults. Arch Surg 1983; 118:617.
  30. Varughese N, Duong A, Emre S, et al. Clinical problem-solving. Venting the spleen. N Engl J Med 2013; 369:1357.
  31. Brancatelli G, Vilgrain V, Zappa M, Lagalla R. Case 80: splenosis. Radiology 2005; 234:728.
  32. Kiser JW, Fagien M, Clore FF. Splenosis mimicking a left renal mass. AJR Am J Roentgenol 1996; 167:1508.
  33. Lake ST, Johnson PT, Kawamoto S, et al. CT of splenosis: patterns and pitfalls. AJR Am J Roentgenol 2012; 199:W686.
  34. Garaci FG, Grande M, Villa M, et al. What is a reliable CT scan for diagnosing splenosis under emergency conditions? World J Gastroenterol 2009; 15:3684.
  35. Sirinek KR, Livingston CD, Bova JG, Levine BA. Bowel obstruction due to infarcted splenosis. South Med J 1984; 77:764.
  36. Basile RM, Morales JM, Zupanec R. Splenosis. A cause of massive gastrointestinal hemorrhage. Arch Surg 1989; 124:1087.
  37. White CS, Meyer CA. General case of the day. Thoracic splenosis. Radiographics 1998; 18:255.
  38. Khosravi MR, Margulies DR, Alsabeh R, et al. Consider the diagnosis of splenosis for soft tissue masses long after any splenic injury. Am Surg 2004; 70:967.
  39. Backhus LM, Bremner RM. Images in clinical medicine. Intrathoracic splenosis after remote trauma. N Engl J Med 2006; 355:1811.
  40. Komforti M, Shi Y, Stoecker M, Wang E. Suspicious mammographic masses in the breast: splenosis in an unusual body site due to a remote ballistic trauma. Br J Haematol 2014; 167:148.
  41. Massey MD, Stevens JS. Residual spleen found on denatured red blood cell scan following negative colloid scans. J Nucl Med 1991; 32:2286.
  42. Fremont RD, Rice TW. Splenosis: a review. South Med J 2007; 100:589.
  43. Yuste JR, Buades J, Guillen EF, Vivas I. Posttraumatic intrathoracic splenosis: from clinical suspicion to noninvasive diagnosis. Am J Med 2014; 127:e3.
  44. Ting W, Silverman NA, Arzouman DA, Levitsky S. Splenic septic emboli in endocarditis. Circulation 1990; 82:IV105.
  45. Robinson SL, Saxe JM, Lucas CE, et al. Splenic abscess associated with endocarditis. Surgery 1992; 112:781.
  46. Johnson JD, Raff MJ, Barnwell PA, Chun CH. Splenic abscess complicating infectious endocarditis. Arch Intern Med 1983; 143:906.
  47. Brook I, Frazier EH. Microbiology of liver and spleen abscesses. J Med Microbiol 1998; 47:1075.
  48. Lee CH, Leu HS, Hu TH, Liu JW. Splenic abscess in southern Taiwan. J Microbiol Immunol Infect 2004; 37:39.
  49. Ebright JR, Alam E, Ahmed H, et al. Splenic infarction and abscess in the setting of infective endocarditis. Infect Dis Clin Pract 2007; 15:17.
  50. Lawrence YR, Pokroy R, Berlowitz D, et al. Splenic infarction: an update on William Osler's observations. Isr Med Assoc J 2010; 12:362.
  51. Sridhar S, Lau SK, Woo PC. A Diagnostic Pitfall: Salmonella Splenic Infarction in Hereditary Spherocytosis. Am J Med 2016; 129:42.
  52. Nores M, Phillips EH, Morgenstern L, Hiatt JR. The clinical spectrum of splenic infarction. Am Surg 1998; 64:182.
  53. Görg C, Seifart U, Görg K. Acute, complete splenic infarction in cancer patient is associated with a fatal outcome. Abdom Imaging 2004; 29:224.
  54. Beeson MS. Splenic infarct presenting as acute abdominal pain in an older patient. J Emerg Med 1996; 14:319.
  55. Barkun AN, Camus M, Green L, et al. The bedside assessment of splenic enlargement. Am J Med 1991; 91:512.
  56. Haan JM, Bochicchio GV, Kramer N, Scalea TM. Nonoperative management of blunt splenic injury: a 5-year experience. J Trauma 2005; 58:492.
  57. Franklin QJ, Compeggie M. Splenic syndrome in sickle cell trait: four case presentations and a review of the literature. Mil Med 1999; 164:230.
  58. Jama AH, Salem AH, Dabbous IA. Massive splenic infarction in Saudi patients with sickle cell anemia: a unique manifestation. Am J Hematol 2002; 69:205.
  59. Al-Salem AH, Naserullah Z, Qaisaruddin S, et al. Splenic complications of the sickling syndromes and the role of splenectomy. J Pediatr Hematol Oncol 1999; 21:401.
  60. Dasanu CA, Codreanu I. Images in clinical medicine. Splenic calcification. N Engl J Med 2011; 365:1042.
  61. Liu Y, Wang X, Wu J. Continuous long-term albendazole therapy in intraabdominal cystic echinococcosis. Chin Med J (Engl) 2000; 113:827.
  62. Abbas MA, Stone WM, Fowl RJ, et al. Splenic artery aneurysms: two decades experience at Mayo clinic. Ann Vasc Surg 2002; 16:442.
  63. Yamazaki K. A case of splenic lymphoma with marked diffuse nodular fibrosis and calcification, complicated with severe autoimmune hemolytic anemia. J Submicrosc Cytol Pathol 2003; 35:17.
  64. Ruiz Carazo E, Muñoz Parra F, Jiménez Villares MP, et al. Hepatosplenic brucelloma: clinical presentation and imaging features in six cases. Abdom Imaging 2005; 30:291.
  65. Wan YL, Cheung YC, Lui KW, et al. Ultrasonographic findings and differentiation of benign and malignant focal splenic lesions. Postgrad Med J 2000; 76:488.
  66. Ha HK, Jung JI, Lee MS, et al. CT differentiation of tuberculous peritonitis and peritoneal carcinomatosis. AJR Am J Roentgenol 1996; 167:743.
  67. Kinoshita T, Ishii K, Yajima Y, et al. Splenic hemangiosarcoma with massive calcification. Abdom Imaging 1999; 24:185.
  68. Ros PR, Moser RP Jr, Dachman AH, et al. Hemangioma of the spleen: radiologic-pathologic correlation in ten cases. Radiology 1987; 162:73.
  69. Fyfe AJ, Gallipoli P. Multiple splenic calcifications. Br J Haematol 2009; 144:808.
  70. Sagoh T, Itoh K, Togashi K, et al. Gamna-Gandy bodies of the spleen: evaluation with MR imaging. Radiology 1989; 172:685.
  71. Hansen MB, Moller AC. Splenic cysts. Surg Laparosc Endosc Percutan Tech 2004; 14:316.
  72. Warshauer DM, Hall HL. Solitary splenic lesions. Semin Ultrasound CT MR 2006; 27:370.
  73. Thipphavong S, Duigenan S, Schindera ST, et al. Nonneoplastic, benign, and malignant splenic diseases: cross-sectional imaging findings and rare disease entities. AJR Am J Roentgenol 2014; 203:315.
  74. Gianom D, Wildisen A, Hotz T, et al. Open and laparoscopic treatment of nonparasitic splenic cysts. Dig Surg 2003; 20:74.
  75. Chin EH, Shapiro R, Hazzan D, et al. A ten-year experience with laparoscopic treatment of splenic cysts. JSLS 2007; 11:20.
  76. Mertens J, Penninckx F, DeWever I, Topal B. Long-term outcome after surgical treatment of nonparasitic splenic cysts. Surg Endosc 2007; 21:206.
  77. Carlin F, Walker AB, Pappachan JM. Spontaneous splenic rupture in an intravenous drug abuser. Am J Med 2014; 127:e7.
  78. Renzulli P, Hostettler A, Schoepfer AM, et al. Systematic review of atraumatic splenic rupture. Br J Surg 2009; 96:1114.
  79. Čolović R, Čolović N, Grubor N, Kaitović M. [Symptomatic calcified splenic artery aneurysm: case report]. Srp Arh Celok Lek 2010; 138:760.
  80. Rahmoune FC, Aya G, Biard M, et al. [Splenic artery aneurysm rupture in late pregnancy: a case report and review of the literature]. Ann Fr Anesth Reanim 2011; 30:156.
  81. Saba L, Anzidei M, Lucatelli P, Mallarini G. The multidetector computed tomography angiography (MDCTA) in the diagnosis of splenic artery aneurysm and pseudoaneurysm. Acta Radiol 2011; 52:488.
  82. Lakin RO, Bena JF, Sarac TP, et al. The contemporary management of splenic artery aneurysms. J Vasc Surg 2011; 53:958.
  83. Giulianotti PC, Buchs NC, Coratti A, et al. Robot-assisted treatment of splenic artery aneurysms. Ann Vasc Surg 2011; 25:377.
  84. Maillard M, Novellas S, Baudin G, et al. [Splenic artery aneurysm: diagnosis and endovascular therapy]. J Radiol 2010; 91:1103.
  85. Picardi M, Martinelli V, Ciancia R, et al. Measurement of spleen volume by ultrasound scanning in patients with thrombocytosis: a prospective study. Blood 2002; 99:4228.
  86. McIntyre OR, Ebaugh FG Jr. Palpable spleens in college freshmen. Ann Intern Med 1967; 66:301.
  87. Tamayo SG, Rickman LS, Mathews WC, et al. Examiner dependence on physical diagnostic tests for the detection of splenomegaly: a prospective study with multiple observers. J Gen Intern Med 1993; 8:69.
  88. Yang JC, Rickman LS, Bosser SK. The clinical diagnosis of splenomegaly. West J Med 1991; 155:47.
  89. Chongtham DS, Singh MM, Kalantri SP, Pathak S. Accuracy of palpation and percussion manoeuvres in the diagnosis of splenomegaly. Indian J Med Sci 1997; 51:409.
  90. Verghese A, Krish G, Karnad A. Ludwig Traube. The man and his space. Arch Intern Med 1992; 152:701.
  91. Barkun AN, Camus M, Meagher T, et al. Splenic enlargement and Traube's space: how useful is percussion? Am J Med 1989; 87:562.
  92. Aito H. The estimation of the size of the spleen by radiological methods. A comparative radiographic, gamma imaging and ultrasonic study. Ann Clin Res 1974; 6 Suppl 15:1.
  93. Silverman S, DeNardo Gl, Glatstein E, Lipton MJ. Evaluation of the liver and spleen in Hodgkin's disease. II. The value of splenic scintigraphy. Am J Med 1972; 52:362.
  94. Downey MT. Estimation of splenic weight from ultrasonographic measurements. Can Assoc Radiol J 1992; 43:273.
  95. Doll M, Schölmerich J, Spamer C, et al. [Clinical significance of sonographically detected splenomegaly]. Dtsch Med Wochenschr 1986; 111:887.
  96. Platzbecker U, Prange-Krex G, Bornhäuser M, et al. Spleen enlargement in healthy donors during G-CSF mobilization of PBPCs. Transfusion 2001; 41:184.
  97. Arkles LB, Gill GD, Molan MP. A palpable spleen is not necessarily enlarged or pathological. Med J Aust 1986; 145:15.
  98. Bezerra AS, D'Ippolito G, Faintuch S, et al. Determination of splenomegaly by CT: is there a place for a single measurement? AJR Am J Roentgenol 2005; 184:1510.
  99. BLACKBURN CR. On the clinical detection of enlargement of the spleen. Australas Ann Med 1953; 2:78.
  100. Stroncek D, Shawker T, Follmann D, Leitman SF. G-CSF-induced spleen size changes in peripheral blood progenitor cell donors. Transfusion 2003; 43:609.
  101. Chun YS, Robu VG. Spectrum of primary vascular neoplasms of the spleen. J Clin Oncol 2011; 29:e116.
  102. Hu S, Bueso-Ramos CE, Verstovsek S, et al. Metastatic splenic angiosarcoma presenting with thrombocytopenia and bone marrow fibrosis mimicking idiopathic thrombocytopenic purpura and primary myelofibrosis: a diagnostic challenge. Clin Lymphoma Myeloma Leuk 2013; 13:629.
  103. Compérat E, Bardier-Dupas A, Camparo P, et al. Splenic metastases: clinicopathologic presentation, differential diagnosis, and pathogenesis. Arch Pathol Lab Med 2007; 131:965.
  104. Pugalenthi A, Bradley C, Gonen M, et al. Splenectomy to treat splenic lesions: an analysis of 148 cases at a cancer center. J Surg Oncol 2013; 108:521.
  105. O'Reilly RA. Splenomegaly in 2,505 patients at a large university medical center from 1913 to 1995. 1963 to 1995: 449 patients. West J Med 1998; 169:88.
  106. Monterroso J, Chandana S. Images in clinical medicine. Massive splenomegaly in hairy-cell leukemia. N Engl J Med 2012; 367:2133.
  107. Bedu-Addo G, Bates I. Causes of massive tropical splenomegaly in Ghana. Lancet 2002; 360:449.
  108. Kamaya A, Weinstein S, Desser TS. Multiple lesions of the spleen: differential diagnosis of cystic and solid lesions. Semin Ultrasound CT MR 2006; 27:389.
  109. Paterson A, Frush DP, Donnelly LF, et al. A pattern-oriented approach to splenic imaging in infants and children. Radiographics 1999; 19:1465.
  110. Metser U, Even-Sapir E. The role of 18F-FDG PET/CT in the evaluation of solid splenic masses. Semin Ultrasound CT MR 2006; 27:420.
  111. Harris NL III. The patient with splenomegaly and lymphocytosis: A diagnostic dilemma. In: Hematology 1998: The American Society of Hematology education program book., p.99.
  112. Iannitto E, Tripodo C. How I diagnose and treat splenic lymphomas. Blood 2011; 117:2585.
  113. Makrin V, Avital S, White I, et al. Laparoscopic splenectomy for solitary splenic tumors. Surg Endosc 2008; 22:2009.
  114. Shapiro AJ, Adams ED. Inflammatory pseudotumor of the spleen managed laparoscopically. Can preoperative imaging establish the diagnosis? Case report and literature review. Surg Laparosc Endosc Percutan Tech 2006; 16:357.
  115. Kraus MD, Fleming MD, Vonderheide RH. The spleen as a diagnostic specimen: a review of 10 years' experience at two tertiary care institutions. Cancer 2001; 91:2001.
  116. Carr JA, Shurafa M, Velanovich V. Surgical indications in idiopathic splenomegaly. Arch Surg 2002; 137:64.
  117. Pottakkat B, Kashyap R, Kumar A, et al. Redefining the role of splenectomy in patients with idiopathic splenomegaly. ANZ J Surg 2006; 76:679.
  118. Lindgren PG, Hagberg H, Eriksson B, et al. Excision biopsy of the spleen by ultrasonic guidance. Br J Radiol 1985; 58:853.
  119. Silverman JF, Geisinger KR, Raab SS, Stanley MW. Fine needle aspiration biopsy of the spleen in the evaluation of neoplastic disorders. Acta Cytol 1993; 37:158.
  120. Moriarty AT, Schwenk GR Jr, Chua G. Splenic fine needle aspiration biopsy in the diagnosis of lymphoreticular diseases. A report of four cases. Acta Cytol 1993; 37:191.
  121. Civardi G, Vallisa D, Bertè R, et al. Ultrasound-guided fine needle biopsy of the spleen: high clinical efficacy and low risk in a multicenter Italian study. Am J Hematol 2001; 67:93.
  122. Lieberman S, Libson E, Maly B, et al. Imaging-guided percutaneous splenic biopsy using a 20- or 22-gauge cutting-edge core biopsy needle for the diagnosis of malignant lymphoma. AJR Am J Roentgenol 2003; 181:1025.
  123. Gómez-Rubio M, López-Cano A, Rendón P, et al. Safety and diagnostic accuracy of percutaneous ultrasound-guided biopsy of the spleen: a multicenter study. J Clin Ultrasound 2009; 37:445.
  124. Olson MC, Atwell TD, Harmsen WS, et al. Safety and Accuracy of Percutaneous Image-Guided Core Biopsy of the Spleen. AJR Am J Roentgenol 2016; 206:655.
  125. McInnes MD, Kielar AZ, Macdonald DB. Percutaneous image-guided biopsy of the spleen: systematic review and meta-analysis of the complication rate and diagnostic accuracy. Radiology 2011; 260:699.
  126. Musallam KM, Khalife M, Sfeir PM, et al. Postoperative outcomes after laparoscopic splenectomy compared with open splenectomy. Ann Surg 2013; 257:1116.
  127. Deeb AP, Kim MJ, Fleming FJ, et al. The impact of operative approach in elective splenectomy: a multivariate analysis of outcomes from the NSQIP database. Surg Laparosc Endosc Percutan Tech 2012; 22:415.
  128. Qu Y, Ren S, Li C, et al. Management of postoperative complications following splenectomy. Int Surg 2013; 98:55.
  129. Bickenbach KA, Gonen M, Labow DM, et al. Indications for and efficacy of splenectomy for haematological disorders. Br J Surg 2013; 100:794.
  130. Musser G, Lazar G, Hocking W, Busuttil RW. Splenectomy for hematologic disease. The UCLA experience with 306 patients. Ann Surg 1984; 200:40.
  131. MacRae HM, Yakimets WW, Reynolds T. Perioperative complications of splenectomy for hematologic disease. Can J Surg 1992; 35:432.
  132. Horowitz J, Smith JL, Weber TK, et al. Postoperative complications after splenectomy for hematologic malignancies. Ann Surg 1996; 223:290.
  133. Nelson EW, Mone MC. Splenectomy in high-risk patients with splenomegaly. Am J Surg 1999; 178:581.
  134. Rosen M, Brody F, Walsh RM, et al. Outcome of laparoscopic splenectomy based on hematologic indication. Surg Endosc 2002; 16:272.
  135. Walsh RM, Brody F, Brown N. Laparoscopic splenectomy for lymphoproliferative disease. Surg Endosc 2004; 18:272.
  136. Patel NY, Chilsen AM, Mathiason MA, et al. Outcomes and complications after splenectomy for hematologic disorders. Am J Surg 2012; 204:1014.
  137. Robinette CD, Fraumeni JF Jr. Splenectomy and subsequent mortality in veterans of the 1939-45 war. Lancet 1977; 2:127.
  138. Mellemkjoer L, Olsen JH, Linet MS, et al. Cancer risk after splenectomy. Cancer 1995; 75:577.
  139. Linet MS, Nyrén O, Gridley G, et al. Risk of cancer following splenectomy. Int J Cancer 1996; 66:611.
  140. Linet MS, Nyrén O, Gridley G, et al. Causes of death among patients surviving at least one year following splenectomy. Am J Surg 1996; 172:320.
  141. Dendle C, Spelman T, Sundararajan V, et al. An analysis of the thromboembolic outcomes of 2472 splenectomized individuals. Blood 2015; 125:1681.
  142. Kristinsson SY, Gridley G, Hoover RN, et al. Long-term risks after splenectomy among 8,149 cancer-free American veterans: a cohort study with up to 27 years follow-up. Haematologica 2014; 99:392.
  143. Sun LM, Chen HJ, Jeng LB, et al. Splenectomy and increased subsequent cancer risk: a nationwide population-based cohort study. Am J Surg 2015; 210:243.
Topic Outline