splenectomy A surgical OPERATIONto remove the
SPLEEN. Though the spleen performs many vital
immune and BLOOD-related functions, it is not
essential for life. Because the spleen contains 4 per-
cent of the body’s blood volume and a third of its
platelets, it is vulnerable to life-threatening hemor-
rhage with trauma. Doctors may also choose to
remove the spleen for therapeutic or prophylactic
(preventive) reasons in conditions such as chronic
myeloid LEUKEMIAand MYELOFIBROSIS.
Splenectomy may be an OPEN SURGERYor a
laparoscopic surgery, depending on the reason and
the person’s overall health status, performed
under general ANESTHESIA. Laparoscopic splenec-
tomy, which involves removing the spleen using a
lighted endoscope and small tools the surgeon
inserts through four or five small incisions in the
upper left abdomen, usually requires an overnight
stay in the hospital with three to four weeks for
full recuperation. Open splenectomy requires a
single incision, four to five inches long, through
which the surgeon opens the abdominal cavity
and removes the spleen. The open surgery may
require three to five days in the hospital with four
to six weeks for full recovery.
COMMON REASONS FOR SPLENECTOMY
hemolytic ANEMIA LEUKEMIA
LYMPHOMA PORTAL HYPERTENSION
THROMBOCYTOPENIA trauma with hemorrhage
uncontrolled SPLENOMEGALY
As with any surgery, excessive bleeding and
INFECTIONare potential risks. Because absence of
the spleen compromises the body’s IMMUNE
RESPONSE, lowered resistance to infection is a com-
mon consequence of splenectomy. Doctors recom-
mend pneumococcal PNEUMONIAvaccination before
splenectomy when possible and immediately after
when splenectomy is an emergency surgery. The
doctor may recommend other immunizations,
depending on individual health circumstances.
People who have had splenectomy must remain
diligent in regard to potential infections, even
those that are seemingly minor such as COLDS.
Many doctors recommend ANTIBIOTIC PROPHYLAXIS
(preventive ANTIBIOTIC MEDICATIONS) to offset the
iMMUNE SYSTEM’s diminished response.
See also SURGERY BENEFIT AND RISK ASSESSMENT.splenomegaly An enlarged SPLEEN. Splenome-
galy signals an underlying health condition and is
not itself a disorder. The spleen is a structure of
lymphatic tissue. One of its key roles is to remove
old or damaged BLOODcells from circulation. Many
circumstances and health conditions that cause
increased numbers of blood cells in the circulation
can also cause splenomegaly. These range from
systemic infections, such as infectious mononucle-
osis, to blood disorders, such as THROMBOCYTHEMIA,
to cancers, such as LEUKEMIAandLYMPHOMA. Some
people feel a sense of uncomfortable fullness with
splenomegaly, though most people are unaware of
the condition until a doctor detects it.
There is no specific treatment for splenomegaly;
so treatment targets the underlying cause.
Splenomegaly significant enough to extend the
spleen beyond the protective boundary of the rib
cage presents a risk for injury resulting in hemor-
rhage, as the spleen contains about 4 percent of
the body’s total blood volume and a third of its
platelets (the cells responsible for clotting).CONDITIONS IN WHICH SPLENOMEGALY MAY OCCUR
AMYLOIDOSIS ANEMIA
CIRRHOSIS congestive HEART FAILURE
HEPATITIS leishmaniasis
LEUKEMIA LEUKOPENIA
LYMPHOMA MALARIA
MONONUCLEOSIS, INFECTIOUS MULTIPLE MYELOMA
MYELOFIBROSIS POLYCYTHEMIA VERA
PORTAL HYPERTENSION psittacosis
SARCOIDOSIS SICKLE CELL DISEASE
SYPHILIS SYSTEMIC LUPUS ERYTHEMATOSUS(SLE)
THALASSEMIA THROMBOCYTHEMIA
THROMBOCYTOPENIA TUBERCULOSISSee also HEPATOMEGALY; SPLENECTOMY.168 The Blood and Lymph