Spleen problems and spleen removal
Spleen problems and spleen removal
Some people are born without a spleen, and others need to have it removed because of disease or injury.
The spleen is an organ about the size of a fist. It sits in the upper left side of your abdomen, next to your stomach and behind your left ribs.
It is an important part of your immune system, but you can live without it. This is because the liver can take over many of the spleen's jobs.
What does the spleen do?
The spleen has a few important jobs.
It fights any germs that get into the blood. The spleen contains white blood cells that fight infection.
It controls the level of blood cells. The spleen keeps the levels of white blood cells, red blood cells and platelets in check. Platelets are small cells that help the blood to clot.
It screens the blood and removes any old or damaged red blood cells.
If the spleen is not working properly, it may start removing healthy blood cells as well. This can lead to:
- anaemia, because there are fewer red blood cells
- a higher risk of infection, because there are fewer white blood cells
- bleeding or bruising, because there are fewer platelets
Spleen problems
Spleen pain
Pain from the spleen is usually felt behind your left ribs. The area may feel tender when you press on it. This can be a sign that the spleen is damaged, ruptured or enlarged.
A damaged or ruptured spleen
The spleen can be damaged, or it may rupture (burst), after a hard blow to the abdomen, a road accident, an injury while playing sport, or a broken rib.
A rupture can happen straight away, or it may happen weeks after the injury.
Signs of a ruptured spleen are:
- pain behind your left ribs, with tenderness when you touch this area
- dizziness and a fast heartbeat, which is a sign of low blood pressure caused by blood loss
Sometimes, if you lie down and raise your legs, the pain can be felt at the tip of your left shoulder.
A ruptured spleen is a medical emergency, because it can cause bleeding that is life threatening.
সাধারণ উপসর্গ
Symptom information is not available for this condition yet.
জরুরি সতর্কতা চিহ্ন
Call 999 or go to A&E straight away if you think you have ruptured or damaged your spleen.
Enlarged spleen
The spleen can become swollen after an infection or injury. It can also become enlarged because of a disease such as cirrhosis, leukaemia or rheumatoid arthritis.
An enlarged spleen does not always cause symptoms. When it does, the signs to look out for are:
- feeling full very quickly after eating, because an enlarged spleen can press on the stomach
- discomfort or pain behind your left ribs
- anaemia, fatigue, or both
- frequent infections
- easy bleeding
Doctors can often tell if you have an enlarged spleen simply by feeling your abdomen. A blood test, CT scan or MRI scan would then confirm the diagnosis.
The spleen is not usually removed if it is just enlarged. Instead, you will receive treatment for any underlying condition and your spleen will be monitored. If there is an infection, antibiotics may be prescribed.
You will need to avoid contact sports for a while, because while the spleen is enlarged you are at greater risk of rupturing it.
Surgery is only necessary if the enlarged spleen is causing serious complications or if the cause cannot be found.
Splenectomy (having the spleen removed)
An operation to remove the spleen, known as a splenectomy, may be needed if the spleen is damaged, diseased or enlarged.
Sometimes it is more appropriate to remove just part of the spleen. This is called a partial splenectomy.
If there is time, you will be advised to have a series of immunisations before the operation.
Laparoscopy
Most splenectomies are carried out using laparoscopy, also known as keyhole surgery.
A laparoscope is a long, thin, flexible instrument with its own light source. It is attached to a camera and sends high definition, magnified pictures back to a TV screen, which guides the surgeon's instruments.
Laparoscopic splenectomy lets the surgeon reach the inside of your abdomen without making large incisions (cuts) in your skin. You will still need a general anaesthetic, however.
The procedure involves:
- making several incisions in your abdomen (tummy area)
- guiding a laparoscope into your body through one of the incisions, so the doctors can see what they are doing
- passing thin instruments into your abdomen through the other incisions to remove your spleen. Gas will be pumped into your abdomen to make this easier
The incisions will then be stitched up, or sometimes glued together. You may be able to go home the same day, or you may need to stay in hospital overnight. If you do go home the same day, someone will need to stay with you for the first 24 hours.
⚠️ এই উপসর্গের তালিকা শিক্ষামূলক উদ্দেশ্যে। এই উপসর্গগুলি থাকার অর্থ এই নয় যে আপনার এই অবস্থা রয়েছে। সঠিক নির্ণয়ের জন্য একজন ডাক্তারের পরামর্শ নিন।
সাধারণত ব্যবহৃত ওষুধ
⚠️ এই ওষুধগুলি সাধারণত এই অবস্থার নিশ্চিত নির্ণয়ের জন্য ব্যবহৃত হয়। এটি একটি সুপারিশ বা প্রেসক্রিপশন নয়। চিকিৎসা অবশ্যই আপনার ডাক্তার দ্বারা নির্ধারিত হতে হবে।
No medicines have been linked to this condition yet.
কখন ডাক্তারের কাছে যাবেন
Phone 999 or go to A&E if:
- you think you’ve ruptured or damaged your spleen
Enlarged spleen
The spleen can become swollen after an infection or injury. It can also become enlarged as a result of a disease such as cirrhosis, leukaemia or rheumatoid arthritis.
An enlarged spleen doesn’t always cause symptoms. Otherwise, look out for:
- feeling full very quickly after eating (an enlarged spleen can press on the stomach)
- feeling discomfort or pain behind your left ribs
- anaemia and/or fatigue
- frequent infections
- easy bleeding
Doctors can often tell if you have an enlarged spleen by feeling your abdomen. A blood test, CT scan or MRI scan would confirm the diagnosis.
The spleen is not usually removed if it’s just enlarged. Instead, you’ll receive treatment for any underlying condition and your spleen will be monitored. Antibiotics may be prescribed if there’s an infection.
You’ll need to avoid contact sports for a while, as you’ll be at greater risk of rupturing the spleen while it is enlarged.
Surgery is only necessary if the enlarged spleen is causing serious complications or if the cause can’t be found.
Splenectomy (having the spleen removed)
An operation to remove the spleen, known as a splenectomy, may be needed if the spleen is damaged, diseased or enlarged.
It may sometimes be more appropriate to have just part of your spleen removed – a partial splenectomy.
If there’s time, you’ll be advised to have a series of immunisations before the operation.
Laparoscopy
Most splenectomies are carried out using laparoscopy (keyhole surgery).
A laparoscope is long, thin, flexible instrument with its own light source. It is attached to a camera and will relay high definition, magnified pictures back to a TV screen to guide the surgeon’s instruments.
Laparoscopic splenectomy allows a surgeon to access the inside of your abdomen without having to make large incisions (cuts) in your skin. However, you will still need a general anaesthetic.
The procedure involves:
- making several incisions in your abdomen (tummy area)
- guiding a laparoscope into your body through one of the incisions, so doctors can see what they’re doing
- passing thin instruments into your abdomen through the other incisions, to remove your spleen – gas will be pumped into your abdomen to make this easier
The incisions will then be stitched up or sometimes glued together. You may be able to go home the same day, or may need to stay in hospital overnight. If you go home the same day, someone will need to stay with you for the first 24 hours.
Treatment
কিহোল সার্জারিতে প্লীহা বের করা সম্ভব না হলে, অর্থাৎ প্লীহা খুব বড় হয়ে গেলে বা খুব বেশি ক্ষতিগ্রস্ত হলে, ওপেন সার্জারির প্রয়োজন হতে পারে। এতে সার্জন একটি বড় কাটা দিয়ে অস্ত্রোপচার করেন। জরুরি অবস্থায় প্রায়ই এই পদ্ধতিই বেছে নেওয়া হয়, কারণ এতে সার্জন দ্রুত রক্তক্ষরণ নিয়ন্ত্রণ করতে পারেন।
এ জন্য আপনাকে জেনারেল অ্যানেসথেসিয়া বা পুরো অবশ করার ওষুধ দেওয়া হবে। সুস্থ হয়ে ওঠার জন্য আপনাকে কয়েক দিন হাসপাতালে থাকতে হতে পারে।
অস্ত্রোপচারের পর
প্লীহা অপসারণের পর ব্যথা আর কালশিটে পড়ার মতো অনুভূতি থাকা স্বাভাবিক। তবে ব্যথা কমানোর ওষুধ আপনাকে দেওয়া হবে।
অস্ত্রোপচারের কিছুক্ষণ পরই আপনি স্বাভাবিকভাবে খাওয়াদাওয়া করতে পারবেন।
যেকোনো অস্ত্রোপচারের মতো প্লীহা অপসারণেও রক্তক্ষরণ ও সংক্রমণসহ কিছু জটিলতার সামান্য ঝুঁকি থাকে। আপনার চিকিৎসক এসব ঝুঁকি নিয়ে আপনার সঙ্গে কথা বলবেন।
বাড়িতে করার জন্য আপনাকে শ্বাসের ব্যায়াম আর পায়ের নড়াচড়ার ব্যায়াম শিখিয়ে দেওয়া হবে। এগুলো রক্ত জমাট বাঁধা বা বুকে সংক্রমণ হওয়ার সম্ভাবনা কমাতে সাহায্য করে।
আরেকটি ঝুঁকি হলো অস্ত্রোপচারের ক্ষত সংক্রমিত হয়ে যাওয়া। সংক্রমণের কোনো লক্ষণ চোখে পড়লে সঙ্গে সঙ্গে চিকিৎসক বা হাসপাতালের সঙ্গে যোগাযোগ করুন, কারণ তখন আপনার অ্যান্টিবায়োটিকের প্রয়োজন হতে পারে।
সুস্থ হয়ে উঠতে সাধারণত কয়েক সপ্তাহ লাগে। গাড়ি চালানোর মতো স্বাভাবিক কাজকর্মে কবে ফিরতে পারবেন, তা আপনার চিকিৎসক বা নার্স আপনাকে জানিয়ে দেবেন।
Complications
Living without a spleen
If your spleen needs to be removed, other organs such as the liver can take over many of the spleen’s functions.
This means you will still be able to cope with most infections. However, there is a small risk that a serious infection may develop quickly. This risk will be present for the rest of your life.
Young children have a higher risk of serious infection than adults, but the risk is still small. The risk is also increased if you have a medical condition such as sickle cell anaemia, coeliac disease or a condition that affects your immune system, such as HIV.
This risk can be minimised by following simple precautions to prevent infection.
Read about vaccinations for children and adults without a fully working spleen.
It’s recommended that you take low-dose antibiotics for the rest of your life to prevent bacterial infections. Antibiotics are particularly important:
- for children under the age of 16
- for the first 2 years after your spleen is removed
- if your immune system doesn’t work properly
Watch out for signs of infection, such as:
- high temperature (fever)
- sore throat
- cough
- severe headache
- headache with drowsiness or a rash
- abdominal pain
- redness and swelling around the surgical wound
Your GP can prescribe a course of antibiotics for you to use if you get an infection. You should start taking them at the first sign of an infection, so see your GP as soon as possible.
If your infection becomes serious, you will be admitted to hospital.
Bites from animals and ticks (small blood-sucking parasites) can cause infections.
If you get bitten by an animal, particularly a dog, start your course of antibiotics and seek medical advice urgently.
If you go trekking or camping regularly, you may be at risk of babesiosis, which is a rare disease transmitted by ticks. Try to avoid tick bites by wearing clothes that cover your skin, particularly long trousers. If you become ill, get medical advice straight away.
Healthcare professionals will mark your health records to show that you don’t have a working spleen. However, always remember to tell any medical professionals that you see, including your dentist.
It’s a good idea to carry or wear some medical ID. For example:
- if your spleen is removed, the hospital may give you a splenectomy card to take home with you
- you may want to buy your own medical ID, such as a MedicAlert or Medi-Tag bracelet or pendant
If you need help or emergency treatment, your medical ID will alert the staff to your condition.
Read advice about travelling abroad without a fully working spleen.
The scars from your operation will gradually fade.
Don’t include personal information e.g. name, location or any personal health conditions.