Presentation
Laparoscopic patients had significantly longer times between presentation and surgery and longer operations, but had significantly less blood loss and fewer transfusions compared with the open group. [ncbi.nlm.nih.gov]
Entire Body System
- Splenectomy
RESULTS: Hemolysis was reduced after subtotal splenectomy and absent after total splenectomy. [ncbi.nlm.nih.gov]
- Pain
The use of reduce port minimizes abdominal trauma and has the hypothetical advantages of shorter postoperative stay, greater pain control, and better cosmesis. [ncbi.nlm.nih.gov]
You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood. Your arm or leg feels warm, tender, and painful. It may look swollen and red. [drugs.com]
Take pain medicines exactly as directed. If the doctor gave you a prescription medicine for pain, take it as prescribed. If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine. [myhealth.alberta.ca]
Deep breathing and relaxation are important to help with pain, keep lungs healthy after anesthesia, and promote good drainage of lymphatic fluid. [oncolink.org]
- Fever
She presented with prolonged fever and respiratory distress. Although broad-spectrum antibiotic therapy had initially been administered, the patient had clinically deteriorated. [ncbi.nlm.nih.gov]
Any fever of greater than 101F must be reported to your primary care physician. If you have any further questions, please do not hesitate to ask any member of Children's Pediatric Surgery Team, Drs. [childrenshospitaloakland.org]
It may begin abruptly with slight sore throat, fever, and "feeling or looking sick," proceed to headache, vomiting, and hyperpyrexia; and be followed within a few hours by convulsions or coma and death. [pediatrics.aappublications.org]
- Surgical Procedure
Venous Thromboprophylaxis Recommendations for Major General, Laparoscopic, and Cancer-Related Surgical Procedures Surgical Procedure Modality Major General Laparoscopic Cancer-Related Unfractionated Heparin Low dose unfractionated heparin (LDUH) 3 times [jaoa.org]
The technical key steps of the surgical procedure are presented in a step by step way: exploration, exposure, dissection, ligation, transection of parenchyma, end of procedure. [websurg.com]
Compared to surgical procedures that remove the head of the pancreas, a distal pancreatectomy is performed in much less time and requires a shorter recovery period. The procedure can also be performed using laparoscopic instruments. [bcm.edu]
CONCLUSIONS: Selective synchronous LSDH is a feasible, effective, and safe surgical procedure with satisfactory short-term efficacy. It is a promising minimally invasive treatment option for patients with cirrhotic HCC and portal hypertension. [ncbi.nlm.nih.gov]
- Sepsis
This postsplenectomy sepsis is discussed further. Key words OPSI-Syndrome • Postsplenectomy sepsis • Streptococcus pneumoniae • Sepsis • Splenectomy This is a preview of subscription content, log in to check access. [link.springer.com]
Splenectomized patients may not develop a fever with sepsis and it is important that if they are feeling unwell and uncomfortable, they should be seen at once as this could be sepsis. [wiskott.org]
Seven patients have had a subsequent admission for infection or sepsis, with one presenting with S. pneumoniae meningitis. None of the patients subsequently admitted for infection or sepsis had received boosters. [ncbi.nlm.nih.gov]
Asplenic-hyposplenic overwhelming sepsis: postsplenectomy sepsis revisited. Pediatr Dev Pathol. 2001; 4 105-121 16 Heiniger U. Prävention schwerer Infektionen bei anatomischer oder funktioneller Asplenie. [doi.org]
Respiratoric
- Cough
You may have more pain when you take deep breaths or cough. You may cough up blood. Your arm or leg feels warm, tender, and painful. It may look swollen and red. [drugs.com]
You should start taking the medication as soon as you get any sign of infection – such as: chills fever a sore throat severe headache new abdominal pain new cough. Ask your prescribing doctor how much you should take. [health.nsw.gov.au]
Be sure to contact your healthcare team with concerning symptoms including: Incisional redness or drainage Bleeding Abdominal swelling Signs of infection such as a fever >100.4 or chills Persistent nausea, vomiting and/or inability to eat or drink A cough [oncolink.org]
"If a patient presents with fever or just general cold and cough kind of symptoms, the recommendation is to have a lower threshold in treating with antibiotics," Dr. Tavakkoli said. [acpinternist.org]
[…] the incision site Infection at the incision site Inflammation of the pancreas ( pancreatitis ) Lung collapse Injury to the pancreas, stomach, and colon Call the doctor right away if you have any of the following after a splenectomy: Bleeding Chills Cough [webmd.com]
Gastrointestinal
- Nausea
A 29-year-old woman presented with nonspecific complaints such as nausea, vomiting, and epigastric discomfort. Further laboratory test results were normal. [ncbi.nlm.nih.gov]
Your medical team will discuss with you the medications you will be taking (blood clot and infection prevention, etc), pain management, nausea management, and constipation prevention. [oncolink.org]
Drawbacks: Typical side effects of general anesthesia including post-operative nausea and vomiting. [cancertherapyadvisor.com]
[…] after a splenectomy: Bleeding Chills Cough or shortness of breath Difficulty eating or drinking Increased swelling of the abdomen Pain that doesn't go away with prescribed medications Increasing redness, pain, or discharge (pus) at the incision site Nausea [webmd.com]
- Vomiting
A 29-year-old woman presented with nonspecific complaints such as nausea, vomiting, and epigastric discomfort. Further laboratory test results were normal. [ncbi.nlm.nih.gov]
It may begin abruptly with slight sore throat, fever, and "feeling or looking sick," proceed to headache, vomiting, and hyperpyrexia; and be followed within a few hours by convulsions or coma and death. [pediatrics.aappublications.org]
You may have a stomach tube coming up out your nose to prevent vomiting or stomach bleeding because your stomach can fill up with stomach juices and not empty properly after this surgery. Not every surgeon uses this tube. [sages.org]
Be sure to contact your healthcare team with concerning symptoms including: Incisional redness or drainage Bleeding Abdominal swelling Signs of infection such as a fever >100.4 or chills Persistent nausea, vomiting and/or inability to eat or drink A cough [oncolink.org]
[…] splenectomy: Bleeding Chills Cough or shortness of breath Difficulty eating or drinking Increased swelling of the abdomen Pain that doesn't go away with prescribed medications Increasing redness, pain, or discharge (pus) at the incision site Nausea or vomiting [webmd.com]
Cardiovascular
- Hypertension
It is a promising minimally invasive treatment option for patients with cirrhotic HCC and portal hypertension. [ncbi.nlm.nih.gov]
[…] thromboembolic disease, hypoxic lung disease, connective tissue disease, idiopathic pulmonary hypertension, and familial pulmonary hypertension associated with mutation of the BMPR2 gene. [thorax.bmj.com]
- Hypotension
In hypotensive patients, the short gastric vessels usually do not bleed, nor does the splenic bed. [emedicine.medscape.com]
Cardiac complications: Hypotension may develop post-operatively if there is ongoing unrecognized bleeding. [cancertherapyadvisor.com]
Skin
- Purpura
Preliminary experience of LS with LCS for a patient with idiopathic thrombocytopenic purpura (ITP) is reported. [ncbi.nlm.nih.gov]
Blood.2004 Nov 1: 104(9): 2623-34 http://www.ncbi.nlm.nih.gov/pubmed/15217831 Fabris F, et al, "Age as the Major Predictive Factor of Long-Term Response to Splenectomy in Immune Thrombocytopenia Purpura", British Journal of Haematology, 2001, vol. 112 [pdsa.org]
Neurologic
- Irritability
She gradually became haemodynamically unstable and displayed signs of peritoneal irritation. Initial attempts of fluid resuscitation failed to improve patient's clinical condition. [ncbi.nlm.nih.gov]
Workup
Serum
- Thrombocytosis
Thrombosis is the most common complication of thrombocytosis, which can be particularly damaging to reattached digits. We present a guideline about digital replantation when thrombocytosis is expected. [ncbi.nlm.nih.gov]
For example, Rostagno et al 12 described a patient who suffered CTEPH associated with long standing thrombocytosis but, when the thrombocytosis was treated, there was improvement in both the clinical state and in the pulmonary haemodynamics. [thorax.bmj.com]
To identify the patients who will develop severe thrombocytosis postoperatively, one has to consider the preoperative platelet count because it proved to be the most reliable predictor of postsplenectomy thrombocytosis. [archsurg.jamanetwork.com]
- Howell-Jolly Bodies
Investigations Blood film: features of hyposplenism include Howell-Jolly bodies, Pappenheimer bodies, target cells and irregular contracted red blood cells. Imaging techniques: ultrasound, CT scanning, and MRI scanning. [patient.info]
Splenectomy patients typically have Howell-Jolly bodies and less commonly Heinz bodies in their blood smears. [en.wikipedia.org]
In this patient, the absence of splenic function was confirmed by the finding of increased circulating pitted red cells and Howell-Jolly bodies. [doi.org]
Its “pitting” function removes cellular inclusions like Heinz and Howell Jolly bodies without destruction of erythrocytes. The spleen is the largest reservoir and disposal site for blood platelets ( Uranüs 1995 ). [ncbi.nlm.nih.gov]
- Leukopenia
The anemia is rarely associated with thrombocytopenia or leukopenia. [ncbi.nlm.nih.gov]
Hypersplenism often led to thrombocytopenia, leukopenia and anemia. Treatment includes drug therapy, liver transplantation, splenic artery embolization and resection of spleen for hypersplenism [ 18 ]. [omicsonline.org]
Laboratory
- Leukocytosis
Low fever was a constant finding not necessarily accompanied with leukocytosis. It was not connected to other septic events and its nature is unclear. [archsurg.jamanetwork.com]
Treatment
After splenectomy, the patient started treatment with ruxolitinib. In the first month of ruxolitinib treatment, the patient became transfusion-free and all constitutional symptoms disappeared. [ncbi.nlm.nih.gov]
Prognosis
There is no significant difference in prognosis between low SV and splenectomy groups, even though the latter had high SV. [ncbi.nlm.nih.gov]
Etiology
Up to now, its etiology remains unknown, and the best surgical procedure is still an area to explore in the future. [ncbi.nlm.nih.gov]
Even after pathohistological examination, the etiology of massive splenomegaly remained unknown. Conclusion. [go.gale.com]
The onset of CTEPH is slower and its etiology is less clear. New studies are helping to enhance understanding. [acpinternist.org]
[…] boy - Image Credit: Suttha Burawonk / Shutterstock Types of splenectomy Splenectomy is performed in different ways: Open splenectomy using a midline or subcostal incision, depending on the need of the surgeon’s need for exposure of the organ, and the etiology [news-medical.net]
Epidemiology
Italy. [email protected]. 3 First Department of Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy. 4 Department of Surgery, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy. 5 Biometry and Clinical Epidemiology [ncbi.nlm.nih.gov]
About this article Publication history Received 25 September 2000 DOI https://doi.org/10.1038/sj.leu.2402129 Further reading Thrombocytopenia in MDS: epidemiology, mechanisms, clinical consequences and novel therapeutic strategies W Li, K Morrone, S Kambhampati [nature.com]
Datta S (2008) An overview of molecular epidemiology of hepatitis B virus (HBV) in India. Virol J 5: 156. Bosch J, Abraldes JG, Berzigotti A, Garcia-Pagan JC (2008) Portal hypertension and gastrointestinal bleeding. Semin Liver Dis 28: 3-25. [omicsonline.org]
Pathophysiology
An outline of the porphyrin pathway reveals the pathophysiological mechanisms that cause porphyria. [7, 8, 9, 10] Biosynthesis of one heme molecule requires 8 molecules of glycine and succinyl-coenzyme A (CoA). [emedicine.com]
The pathophysiological mechanisms by which cellular immune functions are affected by obesity are still under investigation but the spleen may have an important role. [doi.org]
Prevention
We first demonstrated that the incidence of PVST after splenectomy was significantly lower in patients who received the preventive measures than in those who did not (odds ratio [OR]: 0.22, 95% confidence interval [CI]: 0.13-0.39, P CONCLUSION: Preventative [ncbi.nlm.nih.gov]
Your medical team will discuss with you the medications you will be taking (blood clot and infection prevention, etc), pain management, nausea management, and constipation prevention. [oncolink.org]