Splenectomy is the surgical removal of the spleen, which is an organ that is part of the lymphatic system. The spleen is a dark-purple, bean-shaped organ located in the upper left side of the abdomen, just behind the bottom of the rib cage. Splenectomies are performed for a variety of different reasons and with different degrees of urgency. Most splenectomies are done after the patient has been diagnosed with hypersplenism. Hypersplenism is not a specific disease but a group of symptoms, or syndrome, that can be produced by a number of different disorders. It is characterized by enlargement of the spleen (splenomegaly), defects in the blood cells, and an abnormally high turnover of blood cells. It is almost always associated with splenomegaly caused by specific disorders such as cirrhosis of the liver or certain cancers. The decision to perform a splenectomy depends on the severity and prognosis of the disease that is causing the hypersplenism.
There are some disorders in which splenectomy is usually recommended. They include:
Immune Thrombocytopenic Purpura (ITP). ITP is a disease involving platelet destruction. Splenectomy has been regarded as the definitive treatment for this disease and is effective in about 70% of chronic ITP cases. More recently, however, the introduction of new drugs in the treatment of ITP has reopened the question as to whether splenectomy is always the best treatment option.
Trauma. The spleen can be ruptured by blunt as well as penetrating injuries to the chest or abdomen. Car accidents are the most common cause of blunt traumatic injury to the spleen.
Abscesses in the spleen. These are relatively uncommon but have a high mortality rate.
Rupture of the splenic artery. Rupture sometimes occurs as a complication of pregnancy.
Hereditary elliptocytosis. This is a relatively rare disorder. It is similar to HS in that it is characterized by red blood cells with defective membranes that are destroyed by the spleen.
