Purpose of Splenectomy

The spleen is a busy yet underrated abdominal organ that helps to filter and store your blood and fight infections. The spleen performs many important functions—but you can live without it. Find out why you might need your spleen removed through a procedure called a splenectomy.

Diagnosis Related to Splenectomy

Splenectomy, or the surgical removal of the spleen, is most often performed as an emergency procedure after an abdominal injury. Some abdominal injuries can result in injury to the spleen, or even a rupture.

Outside of traumatic injury or rupture, there are a number of conditions for which a splenectomy might be used as a therapeutic or curative treatment. These include:

• Cancers like Hodgkin lymphoma and non-Hodgkin lymphoma
• Certain blood disorders like autoimmune cytopenias and autoimmune hemolytic anemia
• Splenomegaly (enlarged spleen)
• Hypersplenism (an enlarged and overactive spleen)
• Infection
• A clot in the splenic vein or bleeding gastric varices

There are other, less common reasons to have a splenectomy. While rare with the emergence of newer and more effective solutions, these include:

• Myeloproliferative neoplasms, especially myelofibrosis with massive splenomegaly
• Hairy cell leukemia
• Chronic lymphocytic leukemia
• Sickle cell disease with splenic sequestration crisis
• Unexplained splenomegaly
• Splenic lesion

Criteria

Splenectomies can be elective or non-elective—this is you either need it, or you want it. If your splenectomy is non-elective, chances are you need to have your spleen removed to protect your blood supply. Severe problems with the spleen can result in bleeding that can’t be controlled or the destruction of certain types of blood cells.

When determining whether or not to perform a splenectomy, your healthcare provider will consider the following things:

• Are your vital signs—specifically your blood pressure and heart rate—stable?
• Is there uncontrolled, internal bleeding?
• Are there any other surgical needs?

If you need surgery for another injury, your healthcare provider may decide to remove your surgery to avoid the possibility that you need a second operation. Overall, the decision will be made based on how stable your condition is. Some spleen injuries can result in life-threatening bleeding and must be treated right away.

Tests and Labs

To determine whether surgery is necessary, your practitioner will first look at your overall health. This will provide the medical team with information about how quickly you need help. If your surgery is elective, this will also give them information as to how well you might tolerate surgery. Your healthcare provider will check:

• Blood pressure
• Heart rate
• Temperature
• Oxygen level
• Number of breaths per minute
• Basic blood work, like a complete blood count

For both non-emergency and elective procedures, your healthcare provider may also want some more specific diagnostic information like:

• Computerized tomography (CT) scan
• X-ray
• Magnetic resonance imaging (MRI)
• Bone marrow biopsy

These scans can help your healthcare provider determine the extent of the injury or disease to your spleen, and whether blood or other fluids are accumulating in the abdomen. If you rsurgery is related to a trauma or injury and is an emergency, these tests will occur very quickly. In elective cases, these tests could happen over a much longer period of time.

A Word From Verywell

There are many reasons why someone might have a splenectomy. In most cases, splenectomies that are not performed as emergency surgeries are done as a way to address pain or prevent the progression of certain conditions.

If you need a splenectomy to fix an emergent problem or injury, you can survive safely without your spleen. The decision to remove your spleen should be a decision between you and your healthcare provider.