Edit concept Question Editor Create issue ticket

Splenectomy

Splenectomies


Presentation

  • The present case study outlines the early clinical presentation and rapid deterioration of a patient with a splenic injury after an elective colonoscopy. A 70-year-old female underwent a colonoscopy for investigation of altered bowel habit.[ncbi.nlm.nih.gov]
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]
Hodgkin Lymphoma
  • Indications to perform a splenectomy were trauma (n 42), Hodgkin lymphoma (n 24), hereditary spherocytosis (n 21), and immune thrombocytopenia (n 26).[ncbi.nlm.nih.gov]
  • In some situations the spleen is diseased (Hodgkin’s lymphoma, splenic cysts or abscesses) or injured (trauma) whereas in other situations the spleen is removing more blood cells than it should (certain leukemias and lymphomas, certain blood clotting[evergreenhealth.com]
  • Staging for Hodgkin’s Lymphoma (cancer originating in the lymph node)- surgeons will sometimes remove the spleen to determine the extent of involvement and plan of treatment.[laparoscopicexperts.com]
Pseudotumor
  • EPS was attempted in 12 children for various conditions: giant epithelial cyst (n 6), hypersplenism and metabolic disease (n 4), pseudotumor (n 1), and abscess (n 1).[ncbi.nlm.nih.gov]
Constitutional Symptom
  • In the first month of ruxolitinib treatment, the patient became transfusion-free and all constitutional symptoms disappeared.[ncbi.nlm.nih.gov]
Left Upper Quadrant Pain
  • This technique was used in a 15 years old female with epigastric and left upper quadrant pain. An abdominal ultrasound demonstrated a giant cyst located in the spleen. Laboratory tests findings were normal.[ncbi.nlm.nih.gov]
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]

Workup

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]
  • The post-splenectomy platelet count may rise to abnormally high levels (thrombocytosis), leading to an increased risk of potentially fatal clot formation.[en.wikipedia.org]
  • 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]
Howell-Jolly Bodies
  • Splenectomy patients typically have Howell-Jolly bodies and less commonly Heinz bodies in their blood smears.[en.wikipedia.org]
  • Often, Howell-Jolly bodies on peripheral blood film give an important clue to diagnosing hyposplenism. Bone marrow transplantation: splenic irradiation or chronic graft-versus-host disease.[patient.info]
  • […] post-splenectomy: Streptococcus pneumoniae Haemophilus influenzae Neiserria meningitidis Capnocytophaga canimorsus Salmonella spp Malaria Babeosis INVESTIGATIONS FBC/ blood film abnormalities observed post-splenectomy: leukocytosis (acutely) thrombocytosis Howell-Jolly[lifeinthefastlane.com]
  • 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]
Reticulocyte Count Decreased
  • The reticulocyte count decreased significantly from 523   442   10 9 /L before surgery to 267   130   10 9 /L at 6 to 18 months after surgery (31 children) ( P 9 /L [12 children] at 3 to 4 years; 425   194   10 9 /L [8 children] at 5 to 6 years; 327   [doi.org]

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]
  • […] 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]
  • The onset of CTEPH is slower and its etiology is less clear. New studies are helping to enhance understanding.[acpinternist.org]
  • Surgical Indications in Idiopathic (unknown cause of) Splenomegaly archsurg.ama-assn.org A high percentage of patients with splenomegaly of unknown etiology will have primary lymphoma of the spleen.[lymphomation.org]

Epidemiology

  • Italy. a.disabatino@smatteo.pv.it. 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 Further reading Thrombocytopenia in MDS: epidemiology, mechanisms, clinical consequences and novel therapeutic strategies W Li, K Morrone, S Kambhampati, B Will, U Steidl & A Verma[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]
Sex distribution
Age distribution

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]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!