Sacco R, Redler A, Accorinti F, Rosato G
Chir Ital. 1978 Oct;30(5):484-500.
After an examination of the most important physiopathological alterations of splenectomised patients and on the basis of careful research into the literature on study and classification of post-splenectomy hyperthermia, the Authors stress the importance of infections in the genesis of such hyperthermia, until a few years ago defined as "sine causa". On the basis of the consideration that this fever is due to an infection acting on an area (the a-splenic area) which is more vulnerable as it is deprived of a certain part of the reticulo-endothelial system, it was possible to postulate and verify that such hyperthermia could arise only in patients with altered extra-splenic reticulo-endothelial system and hence does not normally occur in patients splenectomised for trauma. On the basis of extensive personal experience, the authors conclude by stressing the therapeutic principles which seem to be most suitable for management of this insidious complication of splenectomy.
在对脾切除患者最重要的生理病理改变进行检查,并在对脾切除术后发热的研究和分类文献进行仔细研究的基础上,作者强调感染在这种发热发生中的重要性,直到几年前这种发热还被定义为“无原因的”。基于这种发热是由于感染作用于一个区域(无脾区域)这一考虑,该区域由于网状内皮系统的某一部分缺失而更易受影响,因此可以推测并证实,这种发热仅会出现在脾外网状内皮系统改变的患者中,所以通常不会发生在因创伤而脾切除的患者身上。基于丰富的个人经验,作者通过强调似乎最适合处理脾切除这种隐匿性并发症的治疗原则来得出结论。