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Splenic Repair in Agnogenic Myeloid Metaplasia

Juan F. Jaramillo, MD; Leroy C. Barry, MD
JAMA. 1980;243(16):1656. doi:10.1001/jama.1980.03300420040024.
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LACERATION of the spleen in a patient with agnogenic myeloid metaplasia (AMM) was successfully treated with splenorrhaphy. Splenectomy is hazardous in AMM, and repair should be a useful alternative.

Report of a Case  A 57-year-old woman was admitted on Oct 21, 1977, to St Mary's Hospital, Saginaw, Mich, after sustaining trauma to the chest and abdomen in a car accident. The patient's condition had previously been diagnosed as AMM.On admission, blood pressure was 100/60 mm Hg; pulse rate, 84 beats per minute; temperature, 36.7 °C. The patient was alert and complained of left upper quadrant pain radiating to the left shoulder. Deep palpation elicited tenderness in the left upper quadrant of the abdomen, with no demonstrable splenomegaly. Laboratory data included the following values: WBCs, 19,400/cu mm, with 43% polymorphonuclear leukocytes, 31% band forms, 15% metamyelocytes, 4% lymphocytes, and 2% monocytes; hemoglobin, 10.5 g/dL; platelets, 309,000/cu mm; prothrombin time, 12.8


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