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Pediatric Surgery International
Published in: Pediatric Surgery International 3/2012

Open Access 01-03-2012 | Original Article

Splenic size after division of the short gastric vessels in Nissen fundoplication in children

Authors: C. Driessen, G. F. Paulus, S. G. Robben, W. E. Tjon a Ten, A. Van den Neucker, B. H. Verhoeven, L. W. E. Van Heurn

Published in: Pediatric Surgery International | Issue 3/2012

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Abstract

Purpose

Nissen fundoplication is an effective treatment for gastro-esophageal reflux disease (GERD). Mobilization of the gastric fundus during fundoplication requires division of short gastric vessels of the spleen, which may cause splenic ischemia. The aim of this study was to determine if Nissen fundoplication results in hypotrophy of the spleen.

Methods

We performed pre-operative and post-operative ultrasound measurements of the spleen in children undergoing Nissen fundoplication. During operation, the surgeon estimated the compromised blood flow by assessment of the percentage of discoloration of the spleen.

Results

Twenty-four consecutive children were analyzed. Discoloration of the upper pole of the spleen was observed in 11 patients (48%) of a median estimated splenic surface of 20% (range 5–50%). The median ratio for pre-operative and post-operative length, width, and area of the spleen was 0.97, 1.03, and 0.96, respectively. The percentage of the estimated perfusion defect during surgery was not correlated with the ratios. In three patients, the area ratio was smaller than 0.8 (0.67–0.75), meaning that the area decreased with at least 20% after surgery. In none of these patients a discoloration was observed.

Conclusion

Discoloration of the spleen after Nissen fundoplication is not associated with post-operative splenic atrophy.
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Metadata
Title
Splenic size after division of the short gastric vessels in Nissen fundoplication in children
Authors
C. Driessen
G. F. Paulus
S. G. Robben
W. E. Tjon a Ten
A. Van den Neucker
B. H. Verhoeven
L. W. E. Van Heurn
Publication date
01-03-2012
Publisher
Springer-Verlag
Published in
Pediatric Surgery International / Issue 3/2012
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-011-3027-9

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