Abstract:Objective
To investigate the cause and management of postsplenectomy fever in portal hypertensive patients.
Methods The clinical data of 295 portal hypertension patients undergoing splenectomy from 1990 to 2003 were reviewed. Among these，80 patients suffered from a continuous fever higher than 38.5℃ for more than 2 weeks postoperatively.
Results Except for two patients with unknown cause, 78 of 295 patients with continuous fever were caused by complications such as splenoportal thrombosis(35 cases), infection of hematocele or hydrops in splenic recess(20 cases), left subphrenic infection(7 cases), pneumonia and hydrothorax or empyema(5 cases), 3 cases each of postoperative abscess of tail of pancreas,winary tract infection and inteclion of surgical incision, 1 case of leakage of esophageal anastomosis and intraabdominal infection in 1 case. The lasting fever was related to the grade of liver function(P<0.01). The surgical modality adopted was not related to the continuous fever or splenoportal thrombosis(P>0.05).
Conclusions Splenoportal thrombosis, and hematocele, hydrops or infection in the splenic recess were the main causes of persistent fever after splenectomy. Prevention and treatment of infection and amelioration of hepatic function will help to reduce the rate of postoperative continuous fever.