What is splenectomy?

Splenectomy

Splenectomy: Overview

A splenectomy (say "splih-NEK-tuh-mee") is surgery to take out the spleen. You may have your spleen taken out because a disease made it get too big. Or maybe your spleen no longer works as it should. The doctor also may remove the spleen if it was damaged in an accident or injury.

Your surgery may be done through one large cut (incision). This is called open surgery. Or you may have laparoscopic surgery. To do this, the doctor puts a lighted tube, or scope, and other tools through several small cuts.

The spleen helps protect you from illness. After your spleen is gone, you may be more likely to get certain infections. So before or soon after your surgery, you will need a pneumococcal shot. You may also need other vaccinations.

Open surgery will leave a scar about 6 to 10 inches long on your belly. Laparoscopic surgery leaves small scars. They will fade over time.

Splenectomy: When to call

Call 911 anytime you think your child may need emergency care. For example, call if:

  • Your child passes out (loses consciousness).
  • Your child has severe trouble breathing.
  • Your child has symptoms of a blood clot in the lung (called a pulmonary embolism). These may include:
    • Sudden chest pain.
    • Trouble breathing.
    • Coughing up blood.

Call your doctor now or seek immediate medical care if:

  • Your child has pain that does not get better after he or she takes pain medicine.
  • Your child has loose stitches, or the incision comes open.
  • Your child has signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • Your child is sick to his or her stomach or cannot drink fluids.
  • Your child has symptoms of a blood clot in the leg (called a deep vein thrombosis), such as:
    • Pain in the calf, back of the knee, thigh, or groin.
    • Redness and swelling in the leg.
  • Bright red blood has soaked through the bandage.
  • Your child cannot pass stool or gas.

Watch closely for any changes in your child's health, and be sure to contact your doctor if:

  • Your child has not had a bowel movement after a couple of days.
  • Your child does not get better as expected.

How do you prepare for your splenectomy?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Talk with your doctor about any vaccines you may need before surgery. The spleen helps the body fight certain types of bacteria. After your spleen is removed, your body will be less able to fight certain serious infections.
  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what procedure is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

How can you care for your child after a splenectomy?

Activity

  • Have your child rest when he or she feels tired.
  • Have your child try to walk a little each day. Make each walk a little longer than the day before.
  • Your child should not ride a bike, play running games, or take part in gym class until your doctor says it is okay.
  • Your child may shower 24 to 48 hours after surgery, if your doctor okays it. Pat the incision dry. Do not let your child take a bath for 1 week, or until your doctor tells you it is okay.

Diet

  • Your child can eat a normal diet. If your child's stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • Have your child drink plenty of fluids to avoid becoming dehydrated.
  • You may notice a change in your child's bowel habits right after surgery. You can help him or her to avoid constipation and straining. Have your child drink plenty of water. The doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

  • Be safe with medicines. Read and follow all instructions on the label.
    • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
    • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
  • If the doctor prescribed antibiotics for your child, give them as directed. Do not stop using them just because your child feels better. Your child needs to take the full course of antibiotics.
  • Your doctor will tell you if and when your child can restart his or her medicines. The doctor will also give you instructions about your child taking any new medicines.

Incision care

  • Your child will go home with a bandage and stitches or staples over the cut (incision) the doctor made. Your doctor may remove your child's stitches or staples 10 to 14 days after the surgery. If your child has stitches that dissolve in the body over time, the doctor will not need to take them out. Your doctor will tell you if your child needs to come back to have any stitches removed.
  • If your child has strips of tape on the incision the doctor made, leave the tape on for a week or until it falls off.
  • You may cover the area with a gauze bandage if it oozes fluid or rubs against clothing.
  • Change the bandage every day.
  • Wash the area daily with warm water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.
  • Keep the area clean and dry.

Preventing infections

  • You will need to take steps to avoid infections in your child. Without a spleen, your child has a higher chance of getting very sick with some infections.
    • If your child did not get all the vaccinations they need before surgery, be sure they get all the vaccines the doctor recommends in the weeks after surgery.
    • Your child may need to take antibiotics each time he or she has a fever. This could be a sign of a serious infection. Ask the doctor what to do if your child has a fever.
    • Do not have your child travel to areas where he or she could get serious infections such as malaria.
    • Have your child avoid contact with people who are sick.
    • Have your child wash his or her hands often.

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