Failure of Accessory Spleens to Prevent Infection Following Splenectomy

To the Editor.  —Drs Zarrabi and Rosner's conclusion¹ that splenosis (ectopic autotransplanted splenic tissue) may not offer protection against post-splenectomy sepsis should be extended to include accessory spleens. Indeed, one of their patients² had an accessory spleen rather than ectopic splenic tissue. We recently saw a 74-year-old man who had splenectomy for trauma ten years prior to admission and who had a recent development of non-insulin-dependent diabetes. He complained of diffuse central abdominal pain of four hours' duration and watery diarrhea of three days' duration. He was nauseated but had not vomited. His rectal temperature was 40 °C and BP 80/50 mm Hg sitting and 110/50 mm Hg supine. The bowel sounds were diminished. He became severely hypoxic soon after admission (arterial oxygen pressure, 49.1 mm Hg; pH, 7.175) and suffered a cardiopulmonary arrest. Resuscitation was unsuccessful. A peripheral blood smear was not done. At autopsy, a pure