THE PRESENT management of idiopathic thrombocytopenic purpura has produced very gratifying therapeutic results. The judicious use of adrenal steroids, fresh blood or platelet transfusions, and splenectomy has stopped many life-threatening hemorrhages and stabilized the clotting process. Our experience with 50 cases1 was reported previously. We did not resort to "emergency splenectomy" in any instance; this is in agreement with the observations of other authors.2,3 We have encountered two cases, however, which emphasize that, in rare instances, splenectomy as an emergency procedure may be invaluable.
We are well aware of the benefits derived from splenectomy in patients with idiopathic thrombocytopenic purpura, and we have stressed this in our report.1 The management of the patient with this disease in whom immediate surgical intervention is necessary, however, has not been emphasized. Reports of emergency splenectomy before definitive surgery are rare. Splenectomy is not a novel procedure, and most hematologists probably