Treatment and Causes of Splenectomy

Splenectomy plays an essential role in your body’s immune system. Located just under the ribcage on the left side, this small organ filters blood, recycles old red blood cells, and stores white blood cells and platelets. However, in some situations, doctors may recommend removing the spleen a surgical procedure known as a splenectomy.

While the idea of removing an organ may sound alarming, it is important to understand that many individuals go on to lead full and healthy lives without a spleen. The decision to perform a splenectomy is never taken lightly; it is usually done when the spleen becomes diseased, enlarged, injured, or contributes to serious blood related disorders. In some cases, a splenectomy may be part of cancer treatment or required urgently after abdominal trauma to save the patient’s life.

What Is a Splenectomy?

A splenectomy is a surgical operation to remove the spleen, either partially or completely. Although the spleen is a vital organ, it is not essential for survival. When the spleen becomes damaged, diseased, or poses a threat to the patient’s health, surgical removal becomes a viable and often life-saving treatment option.

Depending on the underlying condition, the splenectomy may be planned (elective) or performed urgently (emergency). The procedure can be performed using traditional open surgery or minimally invasive laparoscopic techniques.

Treatment and Causes of Splenectomy

Causes of Splenectomy

A splenectomy is usually recommended when the spleen becomes dysfunctional or is at risk of causing serious complications. Several conditions and injuries can lead to this decision:

1. Trauma or Injury :- One of the most common reasons for an emergency splenectomy is trauma to the abdomen. A car accident, sports injury, or a fall can lead to a ruptured spleen, which causes internal bleeding that can be life-threatening if not treated promptly. In such cases, immediate surgical removal of the spleen is often required to prevent further blood loss.

2. Blood Disorders :- Certain blood related conditions can affect spleen function and necessitate removal. Examples include :-

   • Hereditary spherocytosis

   • Thalassemia

   • Sickle cell disease

   • Idiopathic thrombocytopenic purpura (ITP)

   In these disorders, the spleen often becomes enlarged and starts destroying healthy red or white blood cells, leading to anemia, increased infection risk, or bleeding tendencies. A splenectomy can help regulate blood counts and improve quality of life in such cases.

3. Enlarged Spleen (Splenomegaly) :- Splenomegaly, or an abnormally enlarged spleen, may occur due to various reasons, including liver disease, cancer, infections, or autoimmune disorders. In severe cases, the enlarged spleen can begin sequestering or destroying blood cells abnormally or cause pain and discomfort. If non-surgical treatments fail, a splenectomy may be required.
4. Cancers and Tumors :- Certain cancers, such as lymphoma, leukemia, or metastatic tumors, may affect the spleen. In cases where cancer originates in or spreads to the spleen, removing the organ may be part of the broader cancer treatment plan.
5. Cysts or Abscesses :- Infections, cysts, or abscesses in the spleen can be dangerous and difficult to treat with antibiotics alone. If these growths do not respond to medical management or pose a rupture risk, a splenectomy becomes necessary.
6. Autoimmune Conditions :- Autoimmune diseases like systemic lupus erythematosus (SLE) or rheumatoid arthritis can lead to spleen dysfunction. When the spleen exacerbates immune-related destruction of blood cells or contributes to systemic symptoms, surgical removal may offer relief.

Treatment of Splenectomy

The type of splenectomy performed depends on the severity of the condition, the size of the spleen, and the overall health of the patient.

1. Open Splenectomy :- In this traditional method, the surgeon makes a single large incision in the abdomen to remove the spleen. This approach is typically used in trauma cases or when the spleen is significantly enlarged. It allows the surgeon better access and control during complex situations.
2. Laparoscopic Splenectomy :- This minimally invasive method involves making several small incisions and using a tiny camera (laparoscope) to guide the instruments. It is often preferred for elective or less complicated cases because it offers faster recovery, less pain, and minimal scarring.

Preparing for a Splenectomy

If the procedure is elective, you may be advised to undergo certain pre-operative tests, including imaging scans and blood tests. Importantly, because the spleen plays a crucial role in fighting infections, doctors usually recommend vaccinations before the surgery. These may include :-

1. Pneumococcal vaccine

2. Haemophilus influenzae type b (Hib) vaccine

3. Meningococcal vaccine

Getting vaccinated before surgery helps reduce the risk of post splenectomy infections, which can be more severe and harder to treat.

Recovery After Splenectomy

Post operative recovery can vary depending on the surgical technique and individual health status. Patients who undergo laparoscopic splenectomy may return to normal activities within 2–4 weeks, while recovery from open surgery may take longer.

Common post surgical instructions include :-

1. Avoiding heavy lifting for a few weeks

2. Keeping the surgical site clean and dry

3. Taking antibiotics, if prescribed

4. Watching for signs of infection or fever

Most patients can live healthy, normal lives without a spleen. However, long-term preventive care is essential to avoid infections.

Life After Splenectomy

Living without a spleen requires some adjustments, especially regarding infection prevention. Since the spleen filters bacteria and contributes to immune defense, patients become more susceptible to infections, especially from encapsulated organisms like Streptococcus pneumoniae and Neisseria meningitidis.

Here are some important precautions :-

1. Stay up to date with all recommended vaccinations

2. Carry a medical alert ID indicating you don’t have a spleen

3. Seek immediate medical care if you develop fever or signs of infection

4. In some cases, prophylactic antibiotics may be recommended, especially for children or people with weakened immune systems

Potential Risks and Complications

As with any surgery, splenectomy carries some risks. These include :-

1. Bleeding

2. Infection

3. Injury to nearby organs

4. Blood clots

A rare but serious condition known as overwhelming post-splenectomy infection (OPSI) can occur, especially if vaccinations and preventive care are not followed. Prompt medical attention and preventive strategies greatly reduce this risk.

Conclusion

A splenectomy is a significant but manageable surgical procedure often performed to treat serious underlying conditions such as trauma, blood disorders, or cancer. With advances in surgical techniques, particularly laparoscopic splenectomy, recovery times have improved and outcomes are favorable. However, living without a spleen requires lifelong awareness and commitment to infection prevention.