Spleen

Spleen

The spleen is an organ that lies in the left upper part of the abdominal cavity, it is the size of a hand fist, it functions as part of the immunity system that includes also the lymph nodes distributed elsewhere in the human organs and tissues.

It defends the body against encapsulated bacteria that can cause pneumonia, meningitis and septicaemia. Although these infections are rare in patients who lose their spleen, it can be serious and life threatening.

When the spleen is removed you will need specific vaccination against these types of infections

Splenectomy indications 

  1. Trauma, particularly in patients involved in motor vehicle accidents, the spleen is removed because it bleeds seriously
  2. Blood disorders that affect red cells in which the spleen is the main site that cause damage to the red cells such as hereditary spherocytosis and thalassemia.
  3. Autoimmune damage to the platelets that leads to spontaneous bleeding tendency
  4. Lymphoma and certain Leukemias
  5. Enlarged spleen
  6. Splenic cyst
  7. Rare tumours of the spleen
  8. Cancer of the body and tail of the pancreas

Condition, Treatment & Procedure

Splenectomy

Image result for laparoscopic splenectomy

The operation is usually performed as a keyhole surgery, after establishing general anaesthesia the patient is put in a position of lying on their right side, a few cuts are made for the camera and instruments, the operation takes about 60-90 minutes.

The postoperative pain is much less than open surgery and the patient can expect to stay in the hospital for an average of two days. A drain is left in place and the fluid in the drain gets tested usually day one or two for the presence of pancreatic enzymes and removed if the test is negative.

Complications:

  1. Bleeding, which may necessitate blood transfusion or return to theatre
  2. Wound infections like any abdominal surgery
  3. Leak of pancreatic enzymes from the tail of the pancreas; this can occur because the surgery will need to fire a stapler across the splenic blood vessels that are intimately related to the pancreas, which can result in damage to pancreatic tissue.
  4. Risk of certain infections that you will need to have vaccination for.

Long term issues:

After splenectomy your immune system will take over its function. You will be able to resume your life as usual,  but you’re at increased risk of having serious infections.  The highest risk is immediately after the operation.

It is preferable that you get the required vaccines about three weeks before surgery.

After splenectomy, you need to report to the an emergency department if you have any of the following symptoms

  • Fever of (38 C) or higher
  • Red or tender spots on your body
  • Sore throat
  • Chills  or rigors

Make sure your treating  doctor especially for emergency situation knows that you’ve had your spleen removed. A medical alert bracelet is recommended.