Live without Spleen?

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Spleen is a fist-sized organ located in upper left side of your abdomen, behind left ribs and next to the stomach. It fights pathogens in addition to filtering worn out cells out of the bloodstream. Although an important part of immune system, one can survive without spleen, mainly because liver can substitute for many of its functions. Removal of spleen is called splenectomy, following which a person may be more susceptible to infections, preventable by vaccines and antibiotics.

What does the spleen do?

  • Fights invasion of pathogens by raising an army of White Blood Cells (WBCs)
  • Controls count of White Blood Cells (WBCs), Red Blood Cells (RBCs) and Platelets
  • Filters out old or damaged RBCs

Improper function of spleen can lead to removal of healthy WBCs, RBCS and Platelets, leading respectively to

  • Anaemia
  • Increased risk of infection
  • Increased chances of bleeding or bruising

When is splenectomy advised?

A surgeon may advise splenectomy in following disorders of spleen

Ruptured Spleen

Spleen can get damaged or ruptured by a forceful blow to the abdomen as in car accident, sporting accident or fracture to the ribs. Ruptured spleen can cause life-threatening bleeding and needs urgent splenectomy.

Enlarged Spleen

Spleen can become enlarged either due to a viral infection (mononucleosis), a bacterial infection (syphilis), cirrhosis, leukaemia or rheumatoid arthritis. An enlarged spleen destroys excessive number of WBCs, RBCs and platelet, leading to infections, anaemia and bleeding. This is called hypersplenism. If you feel discomfort or pain behind your lower left ribs, you should get yourself evaluated for enlarged spleen. Blood test, CT scan or MRI confirms the diagnosis. It need not be removed just because of being enlarged, but can be managed with medicines and medical supervision. Though you will need to avoid sports to avoid the risk of spleen rupture.

Cancer

Lymphocytic Leukemia, non-Hodgkin’s Lymphoma, and Hodgkin’s disease can cause spleen to enlarge, which can lead to a rupture. The spleen may also need to be removed because of the presence of a cyst or a tumor.

Blood Disorders

Blood disorder refractory to medical treatment may necessitate splenectomy in

  • Sickle cell anemia
  • Hemolytic anemia
  • Idiopathic thrombocytopenic purpura
  • Polycythemia vera

 

Types of Spleen Removal Surgeries

A splenectomy can be performed as a traditional open surgery or as a laparoscopic

Open Splenectomy involves a bigger cut to remove spleen followed by stitches.

Laparoscopic Splenectomy is minimally invasive, quicker, less painful, has shorter recovery, done by laparoscope inserted through small cuts in your abdomen.

Risks of a Spleen Removal

As with any surgical procedure, splenectomy, either open or laparoscopic is not without certain risks like blood loss, infection, stroke or allergy to anaesthesia. Some of these risks can be reduced by antibiotics and exercise. Some risks specific to spleen removal are

  • formation of a blood clot in the vein that takes blood to Liver
  • hernia at the incision site
  • infection
  • collapsed lung
  • damage to the organs near your spleen, including the stomach, colon, and pancreas
  • collection of pus under your diaphragm

Living without a spleen

It is interesting to know that liver can substitute for many function of spleen allowing one to live without it. However for the rest of patient’s life, one may at higher risk of infections, which can minimized with vaccinations against pneumococcal pneumonia, flu, Heamophilus influenza type b (Hib), meningitis C. A low dose prophylactic antibiotic may be required

  • for children under 16 years of age
  • for the first two years after splenectomy
  • if immune system doesn’t work properly

In addition to this, patient needs to be watch out for signs of infection such as

  • sore throat
  • cough
  • high fever
  • severe headache
  • headache with drowsiness or a rash
  • abdominal pain
  • redness and swelling around the surgical wound

It’s better to carry or wear some medical ID to show that you do not working spleen. Knowledge if power. With knowledge and proper precautions, you can prevent things before they get out of control. Do not hesitate to visit a specialist at earliest.

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