SPLEEN REMOVAL

General Information

DEFINITION-Removal of the spleen.

BODY PARTS INVOLVED-The spleen, a large organ on the left side of the upper abdominal cavity next to the stomach.

REASONS FOR SURGERY

• Injury to the spleen causing rupture and bleeding.
• Various blood diseases, including spherocytosis, thrombocytopenia or lymphatic leukemia (See Glossary for all).
• Splenic-vein thrombosis caused by esophageal varices (See Glossary).
• Benign or cancerous tumors.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Newborns and infants.
• Obesity.
• Smoking.
• Excess alcohol consumption.
• Poor nutrition.
• Chronic weakening illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs.

What To Expect

WHO OPERATES-General surgeon.

WHERE PERFORMED-Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of abdomen; CT scan (See Glossary).
• After surgery: Blood studies.

ANESTHESIA-General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made in the abdomen.
• The spleen is located and isolated.
• Blood vessels to the spleen are cut and tied off.
• The spleen is rotated and removed from its bed where it is attached to the coverings of the stomach, kidney and diaphragm (See Glossary).
• If the spleen has been ruptured, the abdomen is explored to identify any other injured organs or blood vessels. Other surgeries may be performed at this time.
• The muscles are closed in layers. The skin is closed with sutures or skin clips, which usually can be removed in about 1 week.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Infection, especially in young children.
• Incisional hernia.
• Atelectasis.
• Pancreatitis.
• Deep-vein blood clots.
• Pneumonia.

AVERAGE HOSPITAL STAY-5 to 7 days.

PROBABLE OUTCOME-Expect complete healing without complications. Allow about 4 weeks for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• A hard ridge should form along the incision. As it heals, the ridge will recede gradually.
• Use an electric heating pad, a heat lamp or a warm compress to relieve incisional pain.
• Bathe and shower as usual. You may wash the incision gently with mild unscented soap.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 6 weeks after surgery. Resume sexual relations when your doctor determines that healing is complete. > Resume driving 4 weeks after returning home.

DIET-Clear liquid diet until the gastrointestinal tract functions again. Then eat a well--balanced diet to promote healing.

Call Your Doctor If

† You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.

• Pain, swelling, redness, drainage or bleeding increases in the surgical area.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.