Patterns of Splenomegaly and Surgical Management at University of Jos Teaching Hospital

Splenomegaly in Nigeria carries a diverse aetiology ranging from malaria and sickle cell disease to haematological malignancies and portal hypertension, with significant implications for surgical management decisions. This study describes the aetiological patterns, indications for splenectomy, and surgical outcomes of splenomegaly cases managed at the University of Jos Teaching Hospital (JUTH), Plateau State, North Central Nigeria, from 2020 to 2024. A retrospective review of 90 cases presenting with clinically and radiologically confirmed splenomegaly requiring surgical consultation was conducted. Data analyzed included aetiology, preoperative haematological parameters, surgical approach, intraoperative findings, and postoperative outcomes. Descriptive statistics were applied. Malaria-related tropical splenomegaly syndrome and sickle cell sequestration were the most frequent aetiologies. Splenectomy was performed in 48 patients, with the majority performed via open approach due to massive splenic enlargement. Postoperative complications included wound infection and overwhelming post-splenectomy infection (OPSI) in three patients. Vaccination against encapsulated organisms was administered in only 62% of post-splenectomy cases. The study recommends systematic post-splenectomy vaccination protocols, prophylactic antibiotic prescribing guidelines, and structured surgical education on splenomegaly management for residents in North Central Nigeria. Keywords: splenomegaly, splenectomy, sickle cell, malaria, Jos