Thrombocytopenic purpura hemorrhagica is characterized clinically by pathologic hemorrhage, ranging from a massive loss in the acute form, usually with a rapid termination, to the milder form, lasting for years. The blood platelets or thrombocytes show marked reduction. Until recently, splenectomy in the fulminating form was considered contraindicated and futile. Killins,1 Reuben and Claman2 and others, however, have reported recoveries from the acute form following splenectomy.
The success of splenectomy in the majority of cases of the chronic form is conceded. A certain number of failures are reported, and these are difficult to explain. Giffin and Holloway3 found no clinical or hematologic improvement in 4 of their 28 cases. Spence,4 out of 101 cases abstracted, found 15 per cent with a return of symptoms.
The commonly accepted theory for the successful results after splenectomy regards the spleen as abnormally destructive to platelets, producing thrombocytopenia and its