What is a splenectomy?

Indications and Procedures

Splenectomy is often performed after trauma to the upper left abdominal cavity that results in injury to the spleen. When the spleen is damaged in such cases, life-threatening intra-abdominal hemorrhage may occur. Surgical repair of the damaged spleen is sometimes difficult, but the lack of a spleen has relatively few ill effects, as other organs such as the liver and tissues of the lymphatic system compensate for its absence. Therefore, splenectomy is usually the indicated treatment for damage to the spleen.

Patients undergoing splenectomy are first anesthetized by an anesthesiologist. Surgical assistants then prepare the patient by scrubbing the upper abdomen to rid the skin of pathogens. The surgeon than makes an incision in the upper left abdomen or along the midline of the abdomen. He or she will then expose the spleen and tie off blood vessels to the spleen with sutures. The surgeon then cuts the attachments that anchor the spleen in the abdomen and removes the organ. This procedure takes approximately one hour to complete, provided that there are no complications. Most patients are allowed to leave the hospital after about one week or less. Although surgical infections are rare, they may require the patient to remain hospitalized for a few more days.

Uses and Complications

Splenectomy is also performed to treat patients with certain types of anemia and hypersplenism. Since the normal function of the spleen is to destroy aged or nonfunctional red blood cells and platelets, overactivity of the spleen in hypersplenism results in excessive destruction of these blood cells and leads to anemia and blood-clotting disorders.

Even though splenectomy has few long-term adverse effects, some adult patients have a slightly increased risk of contracting infections. Splenectomy in children, however, results in greater susceptibility, particularly to pneumococcal pneumonia. Physicians often recommend that children who have undergone splenectomy be immunized against this bacterial pneumonia, and many of these patients even receive long-term prophylactic antibiotic therapy to prevent the disease.

Bibliography

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