Spleen removal – what are the consequences?
The removal of the spleen is known in medical terminology as “splenectomy” (removal of the spleen). The surgical removal of the spleen creates an artificial asplenia (splenelessness). The most common reason why removal of the spleen becomes necessary is a traumatic rupture of the organ (splenic rupture).
In addition, internal diseases that either cause an enormous enlargement of the spleen or lead to life-threatening functional disorders can be an indication for the removal of the organ. In the majority of cases, the removal of the spleen is regarded as an absolute emergency procedure that is performed immediately after diagnosis. However, there are also situations in which the removal of the spleen is possible as a non-emergency procedure.
Among the most common reasons that make a splenectomy necessary are In the emergency situation, surgical access to the spleen is directly through the abdominal cavity. The spleen is then exposed and examined for a possible rupture. If the organ has been identified as a source of bleeding, the bleeding must be stopped by local compression.
If this is successful, the condition of the spleen can be examined more closely and the further surgical procedure can be determined. The spleen is only removed in cases where definitive hemostasis is not possible without removal of the organ. If this is not possible, the actual removal of the spleen begins with the careful separation of the connective tissue connections between the spleen and the tail of the pancreas.
The blood vessels of the spleen are then clamped and the organ removed. In cases where the removal of the spleen is to be performed according to plan, a surgical incision is made along the left costal arch. In addition, laparoscopic removal of the spleen is possible in the absence of a source of bleeding.
However, as with all surgical procedures, the removal of the spleen can lead to serious complications. Among the most frequent complications during the removal of the spleen are problems in the respiratory system. Many patients develop pneumonia shortly after the removal of the spleen.
In addition, the formation of tiny over-inflated areas within the lung tissue and/or pleural effusions may occur.The spleen is an important but not a vital organ. Nevertheless, the removal of the spleen can have a decisive influence on the lifestyle of the patients concerned. After removal of the organ, there is a lifelong increased risk of bacterial infections and fungal diseases.
The immune system is very weak due to a lack of B-lymphocytes and decreased immunoglobulins. In addition, the lack of function of the spleen can cause a significant increase in the number of blood platelets (thrombocytes). In the course of this, there is a risk of blood clots forming.
- Traumatic rupture of the spleen (splenic rupture) for example due to blunt abdominal trauma
- Hereditary spherocytosis
- Hereditary elliptocytosis
- Autoimmune hemolytic anemia
- Thalasemia with need for transfusion
- Sickle cell anemia with transfusion requirement
- Werlhof’s disease
- Thrombotic-thrombocytopenic purpura
- Myelofibrosis
