Surgical aspects of hypersplenism.

Certain blood dyscrasias due to splenic disease that may be amendable to splenectomy have been delineated by the hematologists. Surgery is frequently recommended in these cases, despite alarming deficiencies of blood cells or platelets that cannot be replenished to the commonly accepted safe preoperative levels. A satisfactory outcome, however, is possible if the diagnosis is confirmed by a competent hematologist and a few details of preoperative care are followed by a painstaking technique in splenectomy. Since the surgical aspects of hypersplenism often depend on the type of blood dyscrasia, the surgeon must have a basic understanding of these disease entities in order to work effectively with the hematologist in planning the surgery as well as the preoperative and postoperative care. It is not our intention to discuss the diagnostic and prognostic aspects of hypersplenism, but it will be necessary to define the various types, as they may present problems in