Sudden death and sepsis after splenectomy

This paper has reported two deaths occurring in young adults who had undergone splenectomy for trauma several years before developing pneumococcal sepsis. Tissues at autopsy demonstrated a disproportionate autolysis for the postmortem interval. One victim also showed diffuse serosal hemorrhages, presumably as a result of disseminated intravascular coagulation. Both showed evidence of residual splenic implants but such implants clearly did not provide protection against sepsis. The mechanisms whereby the spleen protects from sepsis appear to be that of a mechanical filter and an immunological organ producing antibody or antibody-like substance. How much splenic tissue and what relationships to the system circulation are necessary to provide protection remain undiscovered.