Splenectomy

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Splenectomy

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Splenectomy

A splenectomy is surgery to remove the entire spleen,
a delicate, fist-sized organ that sits under the left rib cage near the stomach.
The spleen is an important part of the body's defense (immune) system.
It contains special white blood cells that destroy bacteria and help the body fight infections when you are sick. It also helps remove, or filter, old red blood cells from the body's circulation.
If only part of the spleen is removed, the procedure is called a partial splenectomy.
Unlike some other organs, like the liver, the spleen does not grow back (regenerate) after it is removed.

Up to 30% of people have a second spleen (called an accessory spleen). These are usually very small, but may grow and function when the main spleen is removed. Rarely, a piece of the spleen may break off with trauma, such as after a car accident. If the spleen is removed, this piece can grow and function.

Who Needs a Splenectomy?

You may need to have your spleen removed if :
you have an injury that damages the organ,
or causing its covering to break open, or rupture.
A ruptured spleen can lead to life-threatening internal bleeding.
Common injury-related causes of a ruptured spleen include car accidents and severe blows to the abdomen during contact sports, such as football or hockey.

splenectomy may also be recommended if you have cancer involving the spleen or certain diseases that affect blood cells. Certain conditions can cause the spleen to swell, making the organ more fragile and susceptible to rupture. In some cases, an illness, such as sickle cell disease, can cause the spleen to shrivel up and stop functioning. This is called an auto-splenectomy.

The most common disease-related reason for a spleen removal is a blood disorder called idiopathic thrombocytopenic purpura (ITP).

This is an autoimmune condition in which antibodies target blood platelets. Platelets are needed to help blood to clot, so a person with ITP is at risk for bleeding.
The spleen is involved in making these antibodies and removing the platelets from the blood.
Removing the spleen can be done to help treat the condition.

: Other common reasons a person may need a spleen removal include:

: Blood disorders
(Hereditary elliptocytosis (ovalocytosis
Hereditary nonspherocytic hemolytic anemia
Hereditary spherocytosis
(Thalassemia (Mediterranean anemia, or Thalassemia major

: Blood vessel problems:
Aneurysm in the spleen's artery
Blood clot in the spleen's blood vessels

: Cancer:
Leukemia, a blood cancer that affects cells that help the body fight infections.
Certain types of lymphoma, a cancer that affects cells that help the body fight infections.

: Other:
Cyst or abscess (collection of pus) in the spleen

Splenectomy Complications

You can live without a spleen. But because the spleen plays a crucial role in the body's ability to fight off bacteria, living without the organ makes you more likely to develop infections, especially dangerous ones such as Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. These bacteria cause severe pneumonia, meningitis, and other serious infections.
Vaccinations to cover these bacteria should ideally be given to patients about two weeks before planned surgery or roughly two weeks after emergency surgery. Your doctor may recommend other immunizations as well.
Infections after spleen removal usually develop quickly and make the person severely ill. They are referred to as overwhelming post-splenectomy infections, or OPSI.
Such infections cause death in almost 50% of cases. Children under age 5 and people who have had their spleen removed in the last two years have the greatest chance for developing these life-threatening infections.

: Other complications related to splenectomy include:

Blood clot in (the portal vein) the vein that carries blood to the liver
Hernia at the incision site
Infection at the incision site
(Inflammation of the pancreas (pancreatitis
Lung collapse
Injury to the pancreas, stomach, and colon

Preventing Infections After Splenectomy
Children who have their spleen removed often need to take antibiotics every day to prevent them from developing bacterial infections. Adults usually do not need daily antibiotics, unless they become sick or there is a chance they could become sick. People who do not have a spleen who plan on traveling out of the country or to a place where medical help is not available should carry antibiotics to take as soon as they become sick. Also, if you have your spleen removed, ask your doctor about getting a flu shot each year.

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