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Encyclopedia > Splenectomy

A splenectomy is a procedure that involves the removal of the spleen by operative means. The spleen is a ductless, vertebrate gland that is closely associated with the circulatory system, where it functions in the destruction of old red blood cells in holding a reservoir of blood. ... Intraoperative X-Ray of a Humerus fixated by Kirschner wires Surgery (from the Greek meaning hand work) is the medical specialty that treats diseases or injuries by operative manual and instrumental treatment. ...

Contents


Indications

The spleen, similar in structure to a large lymph node, has historically held rather a mythical role but current knowledge of its purpose includes the destruction of old red blood cells and platelets and the detection and fight against certain bacteria. The spleen is enlarged in a variety of conditions such as malaria, glandular fever and most commonly in "cancers" of the lymphatics such as lymphomas or the leukaemia. Structure of the lymph node. ... Human red blood cells Red blood cells are the most common type of blood cell and are the vertebrate bodys principal means of delivering oxygen from the lungs or gills to body tissues via the blood. ... Malaria (from Medieval Italian: mala aria — bad air; formerly called ague or marsh fever) is an infectious disease that is widespread in many tropical and subtropical regions. ... Infectious mononucleosis (also known as mono, the kissing disease, Pfeiffers disease, and, in British English, glandular fever) is a disease seen most commonly in adolescents and young adults, characterized by fever, sore throat and fatigue. ... The lymphatic system is a complex network of lymphoid organs, lymph nodes, lymph ducts, and lymph vessels that produce and transport lymph fluid from tissues to the circulatory system. ... Lymphoma is a variety of cancer that originates in the lymphatic system. ... Leukemia (leukaemia in Commonwealth English) is a group of blood diseases characterized by malignancies (cancer) of the blood-forming tissues. ...


It is removed under the following circumstances:

  1. When very large such that it becomes destructive to platelets/red cells
  2. For diagnosing certain lymphomas
  3. When platelets are destroyed in the spleen as a result of an auto-immune process (see also idiopathic thrombocytopenic purpura)
  4. When the spleen bleeds following physical trauma
  5. Following spontaneous rupture
  6. For long-term treatment of congenital erythropoietic porphyria (CEP) if severe hemolytic anemia develops[1]

The classical cause of traumatic damage to the spleen is a motorcycle accident where one end of the handlebars strikes the abdomen. A 250 ml bag of newly collected platelets. ... Lymphoma is a variety of cancer that originates in the lymphatic system. ... Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ... Idiopathic thrombocytopenic purpura (ITP) is the condition of having a low platelet count (thrombocytopenia) of no known cause (idiopathic). ... In medicine, a trauma patient has suffered serious and life-threatening physical injury resulting in secondary complications such as shock, respiratory failure and death. ... This article is about the disease. ... Hemolytic anemia is anemia due to hemolysis, the abnormal breakdown of red blood cells either in the blood vessels (intravascular hemolysis) or elsewhere in the body (extravascular). ... The examples and perspective in this article or section may not represent a worldwide view. ...


Procedure

In general, spleens are removed by laparoscopy (minimal access surgery) when the spleen is not too large and when the procedure is elective. It is performed by open surgery for trauma or large spleens. Splenectomy is performed under general anesthesia. The spleen is located and disconnected from its arteries. The ligaments holding the spleen in place are dissected and the spleen is removed. When indicated a drain is left in place and the incision(s) is closed. If necessary, tissue samples are sent to a laboratory for analysis. Laparoscopic surgery, also called keyhole surgery (when natural body openings are not used), bandaid surgery, or minimally invasive surgery (MIS), is a surgical technique. ... Intraoperative X-Ray of a Humerus fixated by Kirschner wires Surgery (from the Greek meaning hand work) is the medical specialty that treats diseases or injuries by operative manual and instrumental treatment. ...


Side effects

Because splenectomy causes an increased risk of overwhelming sepsis due to encapsulated organisms (such as S. pneumoniae and Haemophilus influenzae) the patient should be immunized, if possible, prior to removal of the spleen; see asplenia for advice.[2][3] Failure to do so later puts the patient at risk of Overwhelming post splenectomy infection (OPSI), a potentially rapidly fatal septicaemia. These bacteria often cause a sore throat under normal circumstances but after splenectomy, when infecting bacteria cannot be adequately opsonized, the infection becomes more severe. Binomial name Streptococcus pneumoniae Streptococcus pneumoniae is a species of Streptococcus that is a major human pathogen. ... Binomial name Haemophilus influenzae (Lehmann & Neumann 1896) Winslow 1917 Haemophilus influenzae, formerly called Pfeiffers bacillus or Bacillus influenzae, is a non-motile Gram-negative coccobacillus first described in 1892 by Dr. Richard Pfeiffer during an influenza pandemic. ... Asplenia refers to the absence (a-) of normal spleen function and is associated with some risks. ... Sepsis (in Greek Σήψις) is a serious medical condition caused by a severe systemic infection leading to a systemic inflammatory response. ... This page is a candidate to be moved to Wiktionary. ...


Following splenectomy, the platelet count may rise to high levels in blood leading to an increased risk of clot formation.


Notes

  1. ^ Frye R. (2006-03-02). Porphyria, Cutaneous. eMedicine.
  2. ^ (1996). "Guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen. Working Party of the British Committee for Standards in Haematology Clinical Haematology Task Force". BMJ 312 (7028): 430-4. PMID 8601117 Full text.
  3. ^ J M Davies et al (2001-06-02). "The Prevention And Treatment Of Infection In Patients With An Absent Or Dysfunctional Spleen - British Committee for Standards in Haematology Guideline up-date". BMJ. Full text.

  Results from FactBites:
 
Splenectomy (2004 words)
Splenectomy is the surgical removal of the spleen, which is an organ that is part of the lymphatic system.
The decision to perform a splenectomy depends on the severity and prognosis of the disease that is causing the hypersplenism.
Laparoscopic splenectomy is gaining increased acceptance in the early 2000s as an alternative to open splenectomy for a wide variety of disorders, although splenomegaly still presents an obstacle to laparoscopic splenectomy; massive splenomegaly has been considered a contraindication.
CLL Topics: Splenectomy (2325 words)
The role of splenectomy for lymphoproliferative and myeloproliferative malignancies is complex and sometimes controversial.
Although splenectomy is helpful in the management of selected patients with chronic lymphocytic leukemia (CLL), in most cases this procedure is accompanied by a greater morbidity and mortality, mainly due to sepsis.
The good results obtained with subtotal splenectomy in the present case indicate that this procedure may be a new alternative for the treatment of CLL when removal of the spleen is indicated.
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