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spleen

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  • ​​​Spleen is the largest reticuloendothelial organ in the body and lies in the left upper quadrant of abdomen underneath the 9th, 10th, and 11th ribs

  • The spleen acts as a blood filter. It removes the blood cells that are abnormal, old, or damaged. It also fight against infectious micro-organisms such as bacteria, virus and others by producing leukocytes and antibodies. In foetal life, it also produces red & white blood cells

  • It measures 7–11 cm in length, and weighs an average of 150 g (normal range 80–300 g)

  • Normally, it is not palpable. When it becomes palpable, its size should be at least double the normal

  • Approximately 20% of the population has one or more accessory spleens

  • It is the most common injured abdominal organ in blunt trauma

  • In some conditions, spleen enlarges in size (splenomegaly), leading to excessive destruction of even normal blood cells leading to anemia, leukocytopenia & thrombocytopenia, a condition known as "hypersplenism"

  • Splenectomy (Spleen removal) is advised in conditions of hypersplenism, splenic injury, splenic abscess, splenic tumors etc.

  • Splenectomy can be done by both open & laparoscopic surgery

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Discussion 

What are the common indications of splenectomy (removal of spleen) ?

  • Splenic injury- Most common indication of splenectomy

  • Hypersplenism / hemolytic disorders

  • ITP (Idiopathic Thrombocytopenic Purpura)

  • Splenic abscess

  • Splenic tumors etc.

  • Sometimes splenectomy may be needed as a part of other procedures

    • Pancreatico-splenectomy for pancreatic tumors

    • Splenectomy during gastrectomy for gastric cancer

What are the symptoms of splenic disorders?

  • Pain in left upper quadrant

  • Lump (splenomegaly)

  • Anemia, fever etc.

Is there any problem if I undergo splenectomy?​

  • Normally spleen helps in protection from infections/micro organisms, especially capsulated bacteria like H.influenza, pneumococcus etc.

  • When spleen is removed due to any reasons, there will be increased chances of infections with decreased immunity called as OPSI (Overwhelming Post splenectomy Infection)

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What are the precautions to be taken while undergoing splenectomy?

  • When spleen is removed due to any reasons, there will be increased chances of infections with decreased immunity called as OPSI (Overwhelming Post splenectomy Infection)

  • So, vaccination against these organisms are advised at least 2 weeks before elective surgery and 2 weeks after surgery in case of emergency splenectomy like trauma

  • Your doctor may also advise antibiotic prophylaxis for a longer period

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