Health Encyclopedia

Spleen removal

Definition

Spleen removal is surgery is required to remove a diseased or damaged spleen, the body organ that helps the body fight infections.

Alternative Names

Splenectomy

Description

In healthy people, the spleen plays a role in immunity against bacterial infections. The spleen is in the uppermost area of the left side of the abdomen, just under the diaphragm. It typically has attachments to the stomach, left kidney, and colon.

If the surgery is elective (planned) rather than an emergency, your doctor will give you vaccines against certain bacteria prior to removing the spleen. If the operation is an emergency, you should get the vaccines after the operation.

The spleen is removed while the patient is under general anesthesia. The surgeon makes an incision in the abdomen, locates the spleen, and separates it from its attachments to the surrounding organs. The surgeon then divides the blood supply to the spleen and removes it from the abdomen. After a careful check for bleeding, the abdominal incision is closed.

Some patients may be able to undergo laparoscopic surgery (also known as "keyhole" or "telescopic" surgery) to remove the spleen. This operation is done with several tiny incisions instead of a single large one, and recovery is typically faster. Some patients, however, are not suited to laparoscopic surgery.

Indications

Some conditions which may require spleen removal include:

EMERGENCY:

Trauma to the spleen with uncontrolled bleeding
Spontaneous rupture (extremely rare)

ELECTIVE:

Idiopathic thrombocytopenia purpura (ITP)
Congenital or acquired hemolytic anemia
Thrombosis (clot) of the splenic blood vessels
Portal hypertension and hypersplenism
Hereditary spherocytosis
Lymphoma, leukemia with a markedly enlarged spleen

Risks

Risks for any anesthesia include the following:

Reactions to medications
Breathing problems, pneumonia
Heart problems
Blood clots in the legs

Risks for any surgery include the following:

Bleeding
Infection

Additional risks include the following:

Injury to surrounding organs
- Pancreas
- Stomach (rare)
- Colon (rare)
Increased risk for infection after splenectomy (post-splenectomy sepsis or other infections; children are at higher risk than adults for this complication)

Expectations after surgery

The outcome varies with the underlying disease or the extent of other injuries. Complete recovery from the surgery itself should be anticipated, in the absence of other severe injuries or medical problems.

All patients undergoing splenectomy should be vaccinated against pneumococcal pneumonia. Consult your physician regarding an appropriate vaccination regimen. In addition, some physicians recommend vaccinations against other types of bacteria, and, especially in the case of children, long-term treatment with antibiotic drugs to prevent post-splenectomy sepsis. Long-term antibiotic use is usually not necessary in adults.

However, any patients who have had a splenectomy should seek medical attention for even seemingly minor illnesses, such as sinus infections or sore throats, as the health care provider may wish to prescribe antibiotics.

Convalescence

Recovery from the operation should be rapid. Hospitalization is usually less than a week (1-2 days for laparoscopic splenectomy), and complete healing should occur within 4 to 6 weeks.

Review Date:6/7/2006
Reviewed By:J.A. Lee, M.D., Division of Surgery, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.

ADAM Quality A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.