{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T22:07:46Z","timestamp":1759702066131},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[1976,1,1]],"date-time":"1976-01-01T00:00:00Z","timestamp":189302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1976,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>An investigation was carried out of' 821 children under the age of 16 years who were subjected to splenectomy in England and Wales during the 5 years 1 960-4. A postal follow-up study provided satisfactory information concerning 96 per cent of these. Excluding early postoperative deaths, practically all the cases were followed up for 2 years or more and 70 per cent for more than 5 years.<\/jats:p>\n               <jats:p>Forty-nine children had died since operation. 32, from underlying disease and 17 from infection.<\/jats:p>\n               <jats:p>Fifty children (6 per cent of the survivors) had major infections considered to be due to the primary condition aggravated by splenectomy. Seven died, all from the primary disease.<\/jats:p>\n               <jats:p>Sixteen children (2 per cent) developed septicaemic illnesses and 10 died. In these the effect of' splenectomy was considered to be the primary factor. Fourteen of the 16 had been operated on in the first 4 years of life.<\/jats:p>\n               <jats:p>Practically all the serious infections occurred within 3 years of operation and pneumococcus was the organism most frequently implicated.<\/jats:p>\n               <jats:p>Ninety per cent of the splenectomies in childhood were performed, for accidental injury, congenital haemolytic anaemia or idiopathic thrombocytopenic purpura. Accidental injury to the spleen rarely occurs in very young children, and in the other two conditions splenectomy can usually be safely delayed until over the age of 3 years. If this is achieved it is estimated that the unavoidable risk of dangerous infection is less than I per cent.<\/jats:p>\n               <jats:p>One in 10 splenectomies will be curried out for severe und potentially fatal illnesses and in this situation the risk from operation is of secondary importance. Many such conditions carry increased susceptibility to infection per se or because corticosteroids or other immune suppressants are used in their management.<\/jats:p>\n               <jats:p>It is recommended that splenectomy be avoided if at all possible during the early years of life. It is further recommended that prophylactic penicillin be administered for 3 years following operation whatever its indication and whatever the age of the patient. If the underlying condition itself curries risk of infection more active and more prolonged prophylaxis may he indicated.<\/jats:p>","DOI":"10.1002\/bjs.1800630109","type":"journal-article","created":{"date-parts":[[2007,3,2]],"date-time":"2007-03-02T12:57:21Z","timestamp":1172840241000},"page":"36-43","source":"Crossref","is-referenced-by-count":104,"title":["Splenectomy in childhood: A review in England and Wales, 1960\u20134"],"prefix":"10.1093","volume":"63","author":[{"given":"William","family":"Walker","sequence":"first","affiliation":[{"name":"Departments of Haematology and Child Health, Royal Victoria Infirmary . Newcastle upon Tyne"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1976,1,1]]},"reference":[{"key":"2024101409020704600_bib1","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1001\/archpedi.1967.02090200120015","article-title":"Pneumococcal bacteremia","volume":"113","author":"Belsey","year":"1967","journal-title":"Am. J. Dis. Child."},{"key":"2024101409020704600_bib2","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1097\/00000441-197108000-00005","article-title":"Hyposplenism and overwhelming pneumococcal infection: a reappraisal","volume":"262","author":"Bisno","year":"1971","journal-title":"Am. J. Med. Sci."},{"key":"2024101409020704600_bib3","doi-asserted-by":"crossref","first-page":"389","DOI":"10.7326\/0003-4819-72-3-389","article-title":"The syndrome of asplenia, pneumococcal sepsis and disseminated intravascular coagulation","volume":"72","author":"Bisno","year":"1970","journal-title":"Ann. Intern. Med."},{"key":"2024101409020704600_bib4","doi-asserted-by":"crossref","first-page":"727","DOI":"10.4049\/jimmunol.97.5.727","article-title":"YM and YG antibodies in mice: the response to S. Adelaide and the effect of splenectomy","volume":"97","author":"Blinkoff","year":"1966","journal-title":"J. Immunol."},{"key":"2024101409020704600_bib5","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1111\/j.1651-2227.1960.tb16073.x","article-title":"Splenectomy in childhood. A clinical and im-munological study of 42 children splenectomised in the years 1951-1958","volume":"49","author":"Broberger","year":"1960","journal-title":"Acta Paediatr. Scand."},{"key":"2024101409020704600_bib6","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/S0022-3468(75)80009-1","article-title":"Immunological studies in the postsplenectomy syndrome","volume":"10","author":"Claket","year":"1975","journal-title":"J. Pediatr. Surg."},{"key":"2024101409020704600_bib7","first-page":"663","article-title":"Defective phagocytosis due to tuftsin deficiency in splenectomized subjects","volume":"125","author":"Constantopoulos","year":"1973","journal-title":"Am. J. Dis. Child."},{"key":"2024101409020704600_bib8","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1542\/peds.43.5.886","article-title":"Splenectomy in childhood and the hazard of overwhelming infection","volume":"43","author":"Diamond","year":"1969","journal-title":"Pediatrics"},{"key":"2024101409020704600_bib9","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1542\/peds.37.1.111","article-title":"Role of spleen in immunity","volume":"37","author":"Ellis","year":"1966","journal-title":"Pediatrics"},{"key":"2024101409020704600_bib10","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1056\/NEJM196706012762203","article-title":"Hazard of overwhelming infection after splenectomy in childhood","volume":"276","author":"Eraklis","year":"1967","journal-title":"New Engl. J. Med."},{"key":"2024101409020704600_bib11","first-page":"1","article-title":"The hazards of infection following splenectomy in children","volume":"116","author":"Erickson","year":"1968","journal-title":"Am. J. Dis. Child."},{"key":"2024101409020704600_bib12","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1111\/j.1600-0609.1970.tb01912.x","article-title":"Influence of splenectomy on thymic release of lymphocytes into the blood","volume":"7","author":"Ernstr\u00f6m","year":"1970","journal-title":"Scand. J. Haematol."},{"key":"2024101409020704600_bib13","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1002\/1097-0142(197403)33:3<845::AID-CNCR2820330333>3.0.CO;2-6","article-title":"Pneumococcal bacteremia in patients with neoplastic disease","volume":"33","author":"Folland","year":"1974","journal-title":"Cancer"},{"key":"2024101409020704600_bib14","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1111\/j.1651-2227.1967.tb15278.x","article-title":"The differentiation and maturation of specific immune mechanisms","author":"Gitlin","year":"1967","journal-title":"Acta Paediatr. Scand."},{"key":"2024101409020704600_bib15","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1136\/adc.35.181.259","article-title":"Aldrich's syndrome: familial thrombocytopenia, eczema and infection","volume":"35","author":"Gordon","year":"1960","journal-title":"Arch. Dis. Child."},{"key":"2024101409020704600_bib16","doi-asserted-by":"crossref","first-page":"809","DOI":"10.5694\/j.1326-5377.1960.tb23783.x","article-title":"The incidence of infection following splenectomy in childhood","volume":"2","author":"Horan","year":"1960","journal-title":"Med. J. Aust."},{"key":"2024101409020704600_bib17","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1136\/adc.37.194.398","article-title":"Relation between splenectomy and subsequent infection","volume":"37","author":"Horan","year":"1962","journal-title":"Arch. Dis. Child."},{"key":"2024101409020704600_bib18","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1136\/bmj.2.5528.1500","article-title":"Fatal pneumococccal septicaemia after splenectomy","volume":"2","author":"Karatzasn","year":"1966","journal-title":"Br. Med. J."},{"key":"2024101409020704600_bib19","first-page":"135","article-title":"Childhood splenectomy: indications for and results from","volume":"37","author":"Kieswetter","year":"1971","journal-title":"Am, Surg."},{"key":"2024101409020704600_bib20","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1097\/00000658-195208000-00006","article-title":"Splenic studies. I. Susceptibility to infection after splenectomy performed in infancy","volume":"136","author":"King","year":"1952","journal-title":"Ann. Surg."},{"key":"2024101409020704600_bib21","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1093\/infdis\/126.5.507","article-title":"Increased susceptibility of splenectomised rats to infection with Diplococcus pneumoniae","volume":"126","author":"Lai-Sung","year":"1972","journal-title":"J. Infect. Dis."},{"key":"2024101409020704600_bib22","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1136\/bmj.1.5485.446","article-title":"Risk of serious infection following splenectomy","volume":"I","author":"Lowdon","year":"1966","journal-title":"Br. Med. J."},{"key":"2024101409020704600_bib23","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/S0140-6736(62)91476-9","article-title":"Infection following splenectomy in childhood","volume":"1","author":"Lowdon","year":"1962","journal-title":"Lancet"},{"key":"2024101409020704600_bib24","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/S0022-3476(60)80052-2","article-title":"Overwhelming infection following splenectomy","volume":"57","author":"Lucas","year":"1960","journal-title":"J. Pediatr."},{"key":"2024101409020704600_bib25","first-page":"6","article-title":"Haemoglobin S, the pneumococcus and the spleen","volume":"123","author":"Lukens","year":"1972","journal-title":"Am. J. Dis. Child."},{"key":"2024101409020704600_bib26","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/infdis\/130.2.119","article-title":"Meningitis and bacteremia due to Haemophilus influenzae: occurrence and mortality at Boston City Hospital in 12 selected years 1935-1972","volume":"130","author":"McGowan","year":"1974","journal-title":"J. Infect. Dis."},{"key":"2024101409020704600_bib27","first-page":"165","volume-title":"Infectious Agents and Host Reactions","author":"Macleod","year":"1970"},{"key":"2024101409020704600_bib28","first-page":"266","article-title":"Septicaemia following traumatic or incidental splenectomy","volume":"130","author":"Maron","year":"1972","journal-title":"Johns Hopkins Med. J."},{"key":"2024101409020704600_bib29","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1203\/00006450-196705000-00004","article-title":"Effect of antibody upon clearance of I'125 labelled pneumococci by the spleen and liver","volume":"1","author":"Schulkind","year":"1967","journal-title":"Pediatr. Res."},{"key":"2024101409020704600_bib30","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1136\/adc.45.239.114","article-title":"Serum immunoglobulin and transferrin levels after childhood splenectomy","volume":"45","author":"Schumacher","year":"1970","journal-title":"Arch. Dis. Child."},{"key":"2024101409020704600_bib31","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1001\/archsurg.1970.01340260242036","article-title":"Splenectomy for hematologic disorders","volume":"101","author":"Schwartz","year":"1970","journal-title":"Arch. Surg."},{"key":"2024101409020704600_bib32","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1084\/jem.123.5.777","article-title":"Effect of splenectomy on the susceptibility of mice inoculated with Diplococcus pneumoniae","volume":"123","author":"Shinefield","year":"1966","journal-title":"J. Exp. Med."},{"key":"2024101409020704600_bib33","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1136\/bmj.1.5956.516","article-title":"Splenectomy and susceptibility to malaria and babesia infection","volume":"1","author":"Shute","year":"1975","journal-title":"Br. Med. J."},{"key":"2024101409020704600_bib34","first-page":"507","article-title":"Hazard of severe infection in splenectomised infants and children","volume":"92","author":"Smith","year":"1956","journal-title":"Am. J. Dis. Child."},{"key":"2024101409020704600_bib35","first-page":"336","article-title":"Occult pneumococcal bacteriaemia","volume":"119","author":"I'Orphy","year":"1970","journal-title":"Am. J. Dis. Child."},{"key":"2024101409020704600_bib36","first-page":"851","article-title":"Hyposplenism and pneumococcemia. Visualisation of Diplococcus pneumoniae in the peripheral blood smear","volume":"55","author":"Torres","year":"1973","journal-title":"Am. J. Med. Sci."},{"key":"2024101409020704600_bib37","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/S0022-3476(72)80583-3","article-title":"Hereditary thrombocytopenia. Relation to Wiskott-Aldrich syndrome with special reference to splenectomy","volume":"80","author":"Weiden","year":"1972","journal-title":"J. Pediatr."},{"key":"2024101409020704600_bib38","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.5694\/j.1326-5377.1969.tb62293.x","article-title":"Infection and the spleen","volume":"1","author":"Wlllraker","year":"1969","journal-title":"Med. J. Aust."},{"key":"2024101409020704600_bib39","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1056\/NEJM196808292790904","article-title":"Deficiency of pneumococcal serum opsonizing activity in sickle-cell disease","volume":"279","author":"Wlnkltstein","year":"1968","journal-title":"New Engl. J. Med."},{"key":"2024101409020704600_bib40","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/S0022-3476(75)80652-4","article-title":"Pneumococcal serum opsonizing activity in splenectomised children","volume":"87","author":"Winklestein","year":"1975","journal-title":"J. Pediatr."},{"key":"2024101409020704600_bib41","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.4049\/jimmunol.108.6.1681","article-title":"Heat labile opsonins to pneumococcus. III. The participation of immunoglobulin and of the alternate pathway of C3 activation","volume":"108","author":"Winklestein","year":"1972","journal-title":"J. Immunol."},{"key":"2024101409020704600_bib42","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/S0002-9343(70)80116-4","article-title":"Autoimmune haemolytic anaemia. Natural history and viral immunological interactions in childhood","volume":"49","author":"Zuelzer","year":"1970","journal-title":"Am. J. Med."}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.1800630109","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/63\/1\/36\/59745126\/bjs1800630109.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/63\/1\/36\/59745126\/bjs1800630109.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T09:02:38Z","timestamp":1728896558000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/63\/1\/36\/6186509"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1976,1,1]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[1976,1,1]]},"published-print":{"date-parts":[[1976,1,1]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.1800630109","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"type":"print","value":"0007-1323"},{"type":"electronic","value":"1365-2168"}],"subject":[],"published-other":{"date-parts":[[1976,1]]},"published":{"date-parts":[[1976,1,1]]}}}