Splenectomy, Long-Term Care After

A splenectomy is the surgical removal of a diseased or injured spleen. The most common reasons for the spleen to be removed are because of severe injury (trauma), sickle cell disease, or a condition that causes blood clotting problems (idiopathic thrombocytopenic purpura, ITP). The spleen is an organ located in the upper abdomen under your left ribs. It is a sponge-like organ, about the size of an orange, which acts as a filter. The spleen removes waste from the blood, maintains cells that make antibodies to help fight infection, and stores other blood cells.

The spleen, along with other body systems and organs, plays an important role in the body's natural defense system (immune system). Once it is removed, there is a slightly greater chance of developing a serious, life-threatening infection (overwhelming postsplenectomy sepsis). It is important to take extra steps to prevent infection. Other precautions may be necessary to prevent blood clots from forming.

PREVENTING INFECTION

Your caregiver will recommend important steps to help prevent infection. These may include:

  • Making sure your immunizations are up to date, including:

  • Pneumococcus.

  • Seasonal flu (influenza).

  • Haemophilus influenzae type b (Hib).

  • Meningitis.

  • Making sure family members' vaccines are up to date.

  • In some cases, antibiotics may be needed if you get symptoms of infection. Not all patients need this type of treatment after a splenectomy. Talk to your caregiver about what is best for you if these symptoms develop.

  • Following good daily practices to prevent infection, such as:

  • Washing hands often, especially after preparing food, eating, changing diapers, and playing with children or animals.

  • Disinfecting surfaces regularly.

  • Avoiding others with active illness or infections.

  • Taking precautions to avoid mosquito and tick bites, such as:

  • Wearing proper clothing that covers the entire body when you are in wooded or marshy areas.

  • Changing clothing right away and checking for bites after you have been outside.

  • Using insect spray.

  • Using insect netting.

  • Staying indoors during peak mosquito hours.

PREVENTING BLOOD CLOTS

Splenectomy may increase your risk of forming a blood clot. This is of utmost concern immediately after surgery. However, it may continue as a lifelong risk. To help prevent blood clots, your caregiver may recommend:

  • Exercising as directed. Find a safe, regular exercise program that works well for you.

  • Getting up, stretching, and moving around every hour if you sit a lot or do not move about much at work or during travel time.

  • Taking medicines (such as aspirin) as directed.

TRAVEL

If you travel in the U.S., take care to avoid tick bites, especially in the eastern coastal areas. Ticks can spread the parasite that causes babesiosis. Babesiosis is a flu-like illness that is treatable. If you travel abroad where malaria is common, follow these guidelines:

  • Contact your caregiver and discuss the places you are visiting for specific advice.

  • Make sure all of your immunizations are up to date.

  • Get specific immunizations to guard against the disease risk in the country you are visiting.

  • Understand how to prevent infections, such as malaria, abroad. These infections can pose serious risk. Precautions may include:

  • Daily tablets to prevent malaria.

  • Using mosquito nets.

  • Using insect spray.

  • Bring your broad-spectrum, full-strength antibiotics with you.

HOME CARE INSTRUCTIONS

  • Take all medicines as directed. If you are prescribed antibiotics, discuss with your caregiver the use of a probiotic supplement to prevent stomach upset.

  • Keep track of medicine refills so that you do not run out of medicine.

  • Inform your close contacts of your condition. Consider wearing a medical alert bracelet or carrying an ID card.

  • See your caregiver for vaccinations, follow-up exams, and testing as directed.

  • Follow all your caregiver's instructions on managing this and other conditions.

SEEK MEDICAL CARE IF:

  • You have an oral temperature above 102° F (38.9° C).

  • You develop signs of infection, such as chills and feeling unwell, that continue after taking the full-strength antibiotic.

  • You are considering travel abroad.

  • You have questions or concerns.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have chest pain along with:

  • Shortness of breath.

  • Pain in the back, neck, or jaw.

  • You have pain or swelling in the leg.

  • You develop a sudden headache and dizziness.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.