Gastroenterology

Splenectomy Treatment

Splenectomy

Splenectomy is a surgical method for the removal of the patient’s spleen. The spleen is an organ that sits under the rib cage on the upper left side of the people’s abdomen. The spleen helps in fighting the infection and filters out the unneeded material, such as damaged or old blood cells, from the people’s blood.

What is Spleen?

The spleen is a blood filled organ located in the patient’s upper left abdominal cavity. The spleen is a storage organ for red blood cells and contains many specialized white blood cells known as macrophages which act to filter the blood. The spleen is part of the immune system and helps in removing the damaged and old blood particles from the patient’s system.

What is Splenectomy?

Splenectomy is a surgical method for the removal of the patient’s spleen. The spleen is an organ that sits under the rib cage on the upper left side of the people’s abdomen. The spleen helps in fighting the infection and filters out the unneeded material, such as damaged or old blood cells, from the people’s blood. The most common cause for the requirement of splenectomy is for treating a ruptured spleen, which is usually being resulted by an abdominal injury. Splenectomy may be required for treating other conditions, including an enlarged spleen that results in discomfort, infection, noncancerous cysts or tumors, some blood disorders, and certain cancers. Splenectomy is usually done by the use of a tiny video camera and special surgical tools (called laparoscopic splenectomy). With this type of surgery, the patients may be able to leave the hospital the same day and can recover fully in the next two weeks.

Who requires a Splenectomy?Page Image

The patients may be required to have their spleen removed if they have an injury that can damage the organ, resulting in its coverage to break open, or gets rupture. A ruptured spleen can result in life-threatening internal bleeding. Common injuries that have resulted in rupture of the spleen include car accidents and severe blows to the abdomen during contact sports, such as hockey or football.

A splenectomy may also be suggested if the patients have cancer, which involves the spleen or certain diseases that are affecting the blood cells. Certain conditions can result in the spleen to swell, thus making the organ weaker and more prone to rupture. In some of the cases, an illness, known as the sickle cell disease, can result in the spleen to shrivel up and stop its functioning. This is known as an auto-splenectomy.

The most common disease that may cause spleen removal is a blood disorder known as idiopathic thrombocytopenic purpura (ITP). Idiopathic thrombocytopenic purpura (ITP) is an autoimmune condition in which the body’s antibodies target blood platelets. Platelets are required for helping the blood to clot, so a person with idiopathic thrombocytopenic purpura is at risk for bleeding. The spleen is involved in making these antibodies and removes the platelets from the blood. Removing the spleen can be performed for helping to treat this condition.

Other common reasons an individual may require a spleen removal include the following:

Blood disorders:

  • The people have hereditary elliptocytosis (ovalocytosis)
  • The individual is having hereditary nonspherocytic hemolytic anemia
  • The patients are having hereditary spherocytosis
  • The patients having thalassemia (Thalassemia major, or Mediterranean anemia)

Blood vessel problems:

  • The blood vessel problem include aneurysm in the spleen's artery
  • Blood clotting in the spleen's blood vessels

Cancer:

  • Leukemia, a blood cancer that affects cells that help the body fight infections can also cause spleen removal.
  • Certain types of lymphoma, cancer that affects cells that helps the body in fighting the infections.

Other:

  • Abscess or cyst in the spleen

How Is Splenectomy Performed?

The patients will be given general anesthesia a few minutes before they undergo a surgery so that the patients are asleep and do not experience pain while the surgeon is working on them.

There are two ways of doing a splenectomy: open surgery and laparoscopic surgery.

Laparoscopic splenectomy is performed by the use of an instrument called a laparoscope. Laparoscopic is a slender tool with a camera and a light on the end. The surgeon will make three or four small incisions in the patient’s abdomen, and then inserting the laparoscope through one of those incisions. This allows the surgeon to view into the abdominal area and ultimately locating the spleen. Different medical instruments are being passed through the other incisions. One of them is being used for delivering carbon dioxide gas into the patient’s abdominal area, which pushes the nearby organs out of the way and thus giving the surgeon more room to work. The surgeon then disconnects the spleen from the surrounding structures and the patient's blood supply and then removes the spleen through the largest surgical opening. The surgical openings are closed with the help of sutures or stitches. Sometimes during laparoscopic splenectomy, the surgeon has to switch to the open procedure, this may because if the patients have bleeding problems during the surgery. Open splenectomy needs a larger surgical incision than the laparoscopic one. The surgeon makes a cut across the left side or middle of the patient’s abdomen underneath the rib cage. After the spleen has been located, the surgeon will disconnect it from the pancreas and the patient’s body blood supply, and thus removing it. The surgical openings are being closed by the use of sutures or stitches.

What complications can happen?

The people can live without a spleen. But since the spleen plays a vital role in the body's ability in fighting off the bacteria, living without the organ makes the patients more likely to develop infections, especially some dangerous ones such as Streptococcus pneumoniae, Neisseria meningitidies, Haemophilus influenza, and Streptococcus pneumoniae. These bacteria cause severe meningitis, pneumonia, and other serious infections in the body. 

Other complications related to splenectomy include:

  • A blood clot in 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

The patients must call the doctor right away if they have any of the following problems after a splenectomy:

  • Bleeding
  • Chills
  • Shortness of breath or cough
  • Difficulty in drinking or eating
  • Swelling of the abdomen has been increased
  • Pain that doesn't go away with prescribed medicines
  • Increasing pain, redness, or discharge at the cut area
  • Vomiting or nausea that persists
  • Fever more than 101 degrees

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