During the evolution of the understanding of hematologic diseases, the indications for splenectomy have changed. The most common indications for splenectomy are, in descending order of frequency:

A. Traumatic injury, immune thrombocytopenia, hypersplenism.

DISCUSSION: Over the years, the indications for splenectomy have varied as better understanding and altered therapy for immune system diseases have occurred. Whereas in the past splenectomy was the available therapy for hypersplenism, better understanding of the diseases causing hypersplenism (which is a syndrome) has allowed other therapies to emerge. Splenectomy, therefore, is less often required for the treatment of hypersplenism associated with some types of hematologic malignancies. Traumatic injury remains the most common indication for splenectomy, although this situation may change as conservative management of splenic injuries continues to increase. Moreover, immune thrombocytopenia is increasing in frequency and is definitively cured by splenectomy.