The diagnostic value of splenectomy in patients without a definitive preoperative diagnosis

Am J Surg. 2019 Jan;217(1):78-82. doi: 10.1016/j.amjsurg.2018.05.020. Epub 2018 May 29.


Background: The purpose of this study was to describe the diagnostic value and therapeutic benefit of diagnostic splenectomy.

Methods: Retrospective review was performed of patients undergoing splenectomy with an unknown diagnosis (UD), a hematologic malignancy (HM) or idiopathic thrombocytopenic purpura. Surgical indications and postoperative outcomes were evaluated.

Results: 113 splenectomy patients were identified. Of the UD patients undergoing splenectomy, 46% (n = 16) received a definitive diagnosis postoperatively. A change in diagnosis occurred in 12% (n = 4) of HM patients. Complete symptom relief was observed more often in UD patients who received a definitive diagnosis after splenectomy 69% (n = 11), compared to the 47% (n = 9) who did not receive definitive diagnosis postoperatively.

Conclusions: The diagnostic ability of splenectomy was 46% when the diagnosis was unknown preoperatively. Additionally, a majority of patients experienced relief of symptoms postoperatively. Splenectomy may be a useful diagnostic and therapeutic tool in select UD and HM patients.

Keywords: Diagnostic; Hematologic malignancy; Splenectomy.

MeSH terms

  • Diagnostic Techniques, Surgical*
  • Female
  • Hematologic Neoplasms / diagnosis*
  • Hematologic Neoplasms / etiology
  • Hematologic Neoplasms / surgery
  • Humans
  • Lymphoma / complications
  • Lymphoma / diagnosis*
  • Lymphoma / surgery
  • Male
  • Middle Aged
  • Purpura, Thrombocytopenic, Idiopathic / diagnosis*
  • Purpura, Thrombocytopenic, Idiopathic / etiology
  • Purpura, Thrombocytopenic, Idiopathic / surgery
  • Retrospective Studies
  • Splenectomy*
  • Splenomegaly
  • Symptom Assessment