Splenectomy is done to tide over the acute crises of uncontrollable:

Question

Accepted Answer

ITP. **Explanation:**

**1. Why ITP is the Correct Answer:**
Immune Thrombocytopenic Purpura (ITP) is an autoimmune condition where IgG autoantibodies coat platelets, leading to their premature destruction by splenic macrophages. In **acute, life-threatening crises** (such as intracranial or gastrointestinal hemorrhage) where medical management (steroids, IVIG, or platelet transfusions) fails to stabilize the patient, an **emergency splenectomy** is performed. Removing the spleen eliminates both the primary site of platelet destruction and a major source of autoantibody production, leading to a rapid rise in platelet counts.

**2. Why Other Options are Incorrect:**
*   **TTP (Thrombotic Thrombocytopenic Purpura):** The pathophysiology involves a deficiency of the ADAMTS13 enzyme, leading to microthrombi. The primary treatment is **Plasmapheresis (Plasma Exchange)**. Splenectomy is not indicated for acute crises and is rarely considered even in refractory cases.
*   **HUS (Hemolytic Uremic Syndrome):** This is primarily a triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury (often Shiga-toxin mediated). Treatment is supportive (dialysis, fluids); splenectomy has no role in its management.

**3. Clinical Pearls for NEET-PG:**
*   **Indications for Splenectomy in ITP:** Failure of medical therapy (steroids are 1st line), contraindications to steroids, or emergency life-threatening bleeding.
*   **Vaccination Protocol:** For elective splenectomy, vaccinate **2 weeks before** surgery. For emergency splenectomy (like in acute ITP crisis), vaccinate **2 weeks after** surgery.
*   **Target Organisms:** *S. pneumoniae* (most common), *H. influenzae*, and *N. meningitidis*.
*   **Post-Splenectomy Blood Picture:** Look for **Howell-Jolly bodies** (most characteristic), Pappenheimer bodies, Heinz bodies, and target cells. [Practice more Surgery questions on OnCourse]

Surgery Questions

Topics

General Surgery Principles

Preoperative and Postoperative Care

Surgical Infections

Trauma

Head and Neck Surgery

Breast Surgery

Gastrointestinal Surgery

Hepatobiliary Surgery

Pancreatic Surgery

Colorectal Surgery

Vascular Surgery

Endocrine Surgery

Urology

Transplant Surgery

Oncological Surgery

Minimally Invasive Surgery

Bariatric Surgery

Plastic and Reconstructive Surgery

Pediatric Surgery

Surgical Oncology Principles

About Surgery Questions