[Primary hypersplenism due by accessory spleens after splenectomy].

Primary hypersplenism may affect any of the figurative elements of blood, simultaneously or in successive sequences. In function the answers, the therapy may be necessary splenectomy. The authors present the case of a 50-year-old patient what suffered one splenectomy, admitted to the 1st Surgical Clinic for purpuric cutaneous phenomena. 32 years ago, the patient suffered the splenectomy, from a severe autoimmune hemolytic anemia. After 29 years the biologic exam realized for a generalized purple, relieved a severe thrombocytopenia (2,500/mm3) being necessary the administration of thrombocytes transfusion and high doses of corticosteroids in emergency. The spleen sequestration test, ultrasound exam and CT showed the existence of accessory spleens. We practice the surgical intervention for ablation of the accessory spleens. The splenectomy cure disease in 65-80% of cases and the partial remission of manifestation is obtained in 15-20% of cases. The recurrence risk is possible by omission of the accessory spleens. The ablation of these accessory spleens induced recovery in 98-99% of cases.