Splenectomy

The spleen is an organ located in the upper left side of the abdomen under the rib cage. It is normally about the size of a person’s fist. The spleen removes old and damaged blood cells from the bloodstream as they flow through the body. The spleen also removes harmful bacteria from the bloodstream. It helps the body fight against certain kinds of infections.

A child can live a long and active life without a spleen. Because the spleen is important in fighting infection, you will need to take some steps to protect your child. You must be careful to make sure he or she is not exposed to infections. Therefore, watch your child more closely if he does get sick.

Reasons for Splenectomy

A splenectomy (spleen ECT uh me) is an operation to remove the spleen (see Picture 1). The most common reason to remove the spleen is damage to the organ caused by a serious injury. Another reason to remove the spleen is to treat some diseases such as an inherited red blood cell disorder or problems with the platelets, which are cells that help the blood clot.

The splenectomy will be performed under general anesthesia. This means your child will not be awake for the surgery. The surgery can be performed by either the laparoscopic or open method. Laparoscopic surgery is performed by making several small incisions in the abdomen using cameras and special tools to remove the spleen. If needed, one larger abdominal incision will be made using the open method.

Before the Surgery

Your child will need immunizations (shots) before surgery. These may include: Pneumonia, Meningococcal, Haemophilus B (HIB), and flu vaccines. These vaccines protect against the kinds of infections that can be serious in children who do not have spleens.

After the Splenectomy

Prior to your first surgical follow-up appointment, look at the discharge paperwork for your child’s specific care instructions. After your child has a splenectomy, you must take special care to prevent exposing your child to infection.

1. Make sure your child takes medicine as directed. This may include taking an antibiotic every day for many years to protect against getting infections. This is sometimes called a prophylactic (pro fi LACK tic) antibiotic. In some cases, children may stop the prophylactic antibiotic briefly. Then they may be placed on a different antibiotic for a short time. Later they may restart the prophylactic antibiotic.
2. Respond to fever promptly. Any time your child has a fever of 101ºF or greater taken by mouth, call your doctor right away. Remind the doctor that your child does not have a spleen. DO NOT WAIT UNTIL MORNING. Your child should be seen immediately, either in the doctor’s office or an emergency room. Whenever your child has a fever, he must be treated with antibiotics as if he had a serious infection.

3. Watch your child for other signs of infection. Fever is just one sign of infection. Other signs include:

   • More tired than usual
   • Muscle aches
   • Chills
   • Headache
   • Vomiting or diarrhea
   • Belly pain

   These can be warning signs of infection even if your child does not have a fever.

4. Keep your child’s immunizations up to date. This includes a yearly flu vaccine. Your child should not receive a live vaccine.
5. Discuss plans with your doctor before traveling with your child outside of the country.
6. Purchase a Medic Alert bracelet or necklace for your child to wear. Tell all your child’s adult caregivers about the splenectomy.
7. Be sure to keep all your follow-up appointments.

Splenectomy (PDF)

HH-I-256 12/05, Revised 10/14 Copyright 2005, Nationwide Children’s Hospital