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Splenectomy Risks and Benefits

written by: Dr Mike C • edited by: Diana Cooper • updated: 12/29/2010

The spleen has two main functions: filtration of blood to remove old or damaged blood cells and as part of the body's immune response to bacteria, fungi and viruses. This article addresses the spleen's functions and the risks and benefits of a splenectomy; the surgical removal of the organ.

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    The Spleen

    A splenectomy is the surgical removal of the spleen which is sometimes required after a traumatic chest injury, like those that could be sustained in a car crash.

    The human spleen acts as a filter and is a part of the body’s immune system. It is located at the top of the abdomen, on the left side, beneath the ribcage. Roughly the size of a person’s fist, the spleen is a spongy, soft organ. Blood is supplied to the organ via the splenic artery from the heart and it leaves it through the splenic vein which drains into the portal vein. Blood from the spleen is transported to the liver.

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    White And Red Pulp

    There are two distinct components of the spleen known as red pulp and white pulp which are contained inside the splenic capsule; a covering of fibrous tissue. The red pulp is responsible for the filtration function of the spleen, removing old or damaged blood cells from the blood stream. It contains cells called phagocytes which destroy (ingest) microorganisms such as bacteria, fungi and viruses. The red pulp acts as a store for some blood components; white blood cells and platelets. The white pulp provides the immunological functions of the organ. It contains T-cells; B-cells and accessory cells which mount an immunological response when they detect certain antigens within the bloodstream.

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    Surgical Removal Of The Spleen

    A splenectomy is usually performed if the spleen has become irreparably damaged (often as a result of a traumatic injury) and often is carried out as an emergency procedure. If the spleen is ruptured (as a result of trauma), the organ needs to be removed to stem blood loss due to internal haemorrhage which could quickly become fatal if left untreated. An emergency, life-saving treatment may be seen as a benefit of removal of the spleen, of course, but it may be needed to treat other conditions, in a non-emergency context, including certain blood disorders, infection, certain cancers and non-cancerous tumours or cysts and to treat splenomeagly (an enlarged spleen).

    Any surgical intervention has risks associated with it, such as infection or a reaction to anaesthesia. A spelenectomy is associated with risks of bleeding, blood clots (which may travel to remote parts of the body (eg heart, brain, lungs etc)) or trauma to adjacent organs (stomach, pancreas and colon).

    It is widely believed that removal of the spleen is not a critical issue since the organ’s functions can be carried out by other tissues. However, patients are at increased risk from infection from some bacteria (eg streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae) and may require vaccinations or antibiotic medication to protect them from these illnesses.

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    References

    1. The Spleen, Merck Manuals: http://www.merckmanuals.com/home/sec14/ch179/ch179a.html
    2. Texas Pediatric Surgery Associates: http://www.pedisurg.com/pteduc/spleen.htm
    3. The Anatomy of the immune system: http://www.microbiologybytes.com/iandi/2b.html
    4. Splenectomy, Mayo Clinics: http://www.mayoclinic.com/health/splenectomy/MY01271