To the Editor.—A recent article1 on the incidence of residual splenic tissue following splenectomy for trauma described a 26% occurrence of splenosis. This is at odds with other reports of splenosis, where an incidence of 50% is claimed.2 My colleagues and I recently studied 33 randomly selected patients at a median interval of 72 months following splenectomy for splenic injury and found a 67% incidence of splenosis.3 This much higher incidence may be related to the use of the heat-damaged erythrocyte technique for the demonstration of splenic regeneration, while Livingston et al used technetium Tc 99m sulfur colloid.
We also studied erythrocyte morphology in fresh, glutaraldehyde-fixed blood samples. With our much higher incidence of splenosis, however, we were able to show an inverse relationship between the approximate volume of splenic regeneration and the percentage of pitted RBCs present.
The authors contended that serum IgM levels were