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Splenectomy

Splenectomy or spleen removal surgery is resorted only when there is no other choice but to remove the infected or damaged spleen. Splenectomy is also resorted to in case of cancers involving the spleen such as leukemia or Hodgin lymphoma, severe lupus or blood disorders such as sickle cell disease or thalassemia. Idiopathic thrombocytopenic purpura is a blood disorder that often necessitates spleen removal. Splenectomy can be done in traditional open style or by laparoscopic method. The spleen functions include making antibodies and removing antibody-coated blood cells. So a Splenectomy leaves a person with a compromised immune system. Post spleen removal, patients are at higher risk for infections and blood vessel complications. Antibiotic prophylaxis and yearly vaccines are prescribed.


Splenomegaly

The spleen is responsible for the production of humoral antibodies and is a reservoir for blood cells. In case of Splenomegaly, the functions associated with the spleen are hampered. Enlarged spleen or Splenomegaly generally indicates the presence of an underlying medical condition which has to be attended to immediately. Physicians palpate the patient and observe the size variation that is clinically correlated with Splenomegaly. This routine examination is followed by other diagnostic tests which include blood, urine and body fluid analysis to identify the presence of infection.


Symptoms of Splenomegaly

The occurrence of Splenomegaly is usually asymptomatic unless there is an underlying factor such as bacterial, viral or parasitic infection. In most cases, patients complain of upper abdominal discomfort or pain, decreased appetite, weakness because of anemia and susceptibility to infections.

Splenomegaly predominantly occurs because of infections. However other metabolic disorders such as Niemann pick and Gaucher's disease can also serve as diagnostic markers. The susceptibility of Splenomegaly is high among children and elderly persons. Enlarged spleen can be life threatening as it may lead to splenic rupture in the abdominal cavity.

Treatment options for Splenomegaly include treating the underlying infection by administration of antibiotics. Post operative patients must be given antibiotics such as penicillin to avoid relapse of infections. In case of splenic enlargement, contact sports such as football, wrestling, boxing must be avoided. Children must be given vaccinations for Pneumococci, Haemophilus influenza (Bacillus Influenzae) on schedule to avoid infections. Splenectomy is the surgical choice in cases of total spleen malfunction or rupture.



Hypersplenism

The spleen is one of the most important organs in the body. It enables the production of blood cells and also facilitates the removal of unwanted cells or worn out blood cells from the blood stream. The spleen is a significant promoter for erythropoiesis process. Hypersplenism is a complex condition associated with the functionality of the spleen in removing the blood cells. In case of hypersplenism, the activity of the spleen is increased leading to early destruction of the cells which are healthy. In some cases the spleen holds up platelets and healthy RBCs thereby leading to altered hematological functions in the body such as clotting and oxygen supply to various organs. Another possible cause of Hypersplenism is Splenomegaly which refers to enlargement of the spleen.


Clinical manifestations of Hypersplenism

The incidence of hypersplenism is closely associated with underlying conditions such as tuberculosis, malaria, cirrhosis, rheumatoid arthritis and polycythemia. The clinical manifestations of hypersplenism include susceptibility to bacterial infections and viral infections such as infectious mononucleosis. In most cases, hypersplenism is caused because of predisposing factors such as alcoholic liver cirrhosis.

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Bibliography / Reference

Collection of Pages - Last revised Date: November 22, 2019