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  • Title: Laparoscopic accessory splenectomy in recurrent chronic immune thrombocytopenic purpura.
    Author: Rogers J, Yousuf A, Kleinhaus S.
    Journal: Surg Laparosc Endosc; 1997 Apr; 7(2):83-5. PubMed ID: 9109231.
    Abstract:
    Splenectomy is the definitive treatment for most cases of idiopathic thrombocytopenic purpura (ITP). We present the case of a patient who was discovered to have ITP at age 5 and was treated medically for 3 years with decreasing response to medication. At age 8, he underwent splenectomy, after which the platelet count stabilized at approximately 200,000/mm3. Two years later he again had symptoms of thrombocytopenia and was treated medically with moderate success. At age 12, during hospitalization for bleeding, his liver/spleen scan gave negative results. Symptoms persisted, and when the patient was 13 a second scan found two small areas of uptake in the area of the splenic bed suggestive of secondary accessory splenic activity. The platelet count at that time was 6,000/mm3. Laparoscopy was performed, and after careful dissection of the left-upper quadrant, two globular masses, the larger of which was 3 x 2 x 2 cm, were removed without incident. The latest platelet count, 3 months after laparoscopic secondary accessory splenectomy, was 169,000/mm3, and a follow-up scan shows no uptake in the area of the spleen.
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