Although the association of asplenia and overwhelming bacterial septicemia was first reported more than 20 years ago, it has taken considerably longer to make practical strides in avoiding splenectomy. The large experience of Pearl and colleagues demonstrates that we can avoid splenectomy ever more often.

The treatment of splenic injuries during a period of 5 years was reviewed and compared to the management of patients during the previous 5 years. The number of patients who did not require surgery increased from 70% to 87%, those requiring blood transfusion decreased from 36% to 23%, and the number undergoing a total splenectomy decreased from 24% to 4%.

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