The spleen is one of the first organs injured in sickle cell disease (SCD) [1]. Splenic impairment in SCD children can silently progress toward functional asplenia, exposing patients to an increased risk of invasive bacterial infections, or it can manifest abruptly as acute splenic sequestration crisis (ASSC), a life-threatening event whose recurrence may justify a splenectomy [1]. In recent years, subtotal splenectomy has emerged as an alternative to total splenectomy with the aim of preserving splenic functions, including clearance of pathogenic erythrocytes and protection against bacterial infections. However, some studies have reported that subtotal splenectomy may lead to a higher incidence of intraoperative and postoperative complications [2]. Furthermore, concerns persist regarding the lack of significant long-term benefit of subtotal over total splenectomy, as progression of SCD usually results in auto-splenectomy of the remaining spleen tissue
