שאלה משלב א׳ בכירורגיית ילדים · מועד 2024 (Sep), שאלה 61

Correct: D — a high BMI is a risk factor for conversion of laparoscopic splenectomy to open surgery. Obesity limits exposure, lengthens instrument reach and makes hilar dissection harder. Option A is wrong because hereditary spherocytosis gives a normal-sized or modestly enlarged spleen and is the easiest indication laparoscopically; option B is wrong because accessory spleens in the omentum are searched for and removed but do not force conversion; option C is wrong because younger children are not harder — massive splenomegaly, which is more common in older children with haematological disease, is the real driver of conversion.

מקור: Coran-Holcomb p. 758