# Splenic Trauma in the Immunocompromised: Unveiling Complexities and Dilemmas

## TL;DR

This paper discusses the increased risk of severe infections after spleen removal in people with weakened immune systems, highlighting the need for better guidelines and research.

## Contribution

The paper presents a case study of an immunocompromised patient with HIV and HCV who underwent splenectomy, emphasizing the lack of evidence-based strategies for this population.

## Key findings

- Splenectomy increases the risk of sepsis, especially in immunocompromised individuals.
- Current postoperative strategies lack evidence for immunocompromised patients.
- A case of a young male with HIV and HCV is presented to illustrate management challenges.

## Abstract

The incidence of splenectomy due to traumatic injuries has decreased globally, owing to the advancements in hospital facilities and angioembolization techniques. Nevertheless, some patients still undergo splenectomy, leading to a lifelong risk of post-splenectomy sepsis. This risk is particularly heightened in immunocompromised individuals, presenting significant challenges in managing and preventing such infections. Compounding these challenges is the absence of comprehensive national guidelines and a splenic registry. While there have been improvements in postoperative prophylaxis through vaccination, patient education, and antibiotic usage, evidence supporting these strategies in immunocompromised patients remains lacking. Thus, there is an urgent need for expanded research in these areas to mitigate the morbidity and mortality associated with post-splenectomy sepsis in this vulnerable population. We report our experience of a young male having a penetrating abdominal injury who underwent splenectomy and had an immunocompromised status with both Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) positive status.