Splenectomy Health Article

Definition

A splenectomy is the total or partial surgical removal of the spleen, an organ that is part of the lymphatic system.

Purpose

The human 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. In adults, the spleen is about 4.8 X 2.8 X 1.6 in (12 X 7 X 4 cm) in size, and weighs about 4–5 oz (113–14 g). The spleen plays a role in the immune system of the body. It also filters foreign substances from the blood and removes worn-out blood cells. The spleen regulates blood flow to the liver and sometimes stores blood cells—a function known as sequestration. In healthy adults, about 30% of blood platelets are sequestered in the spleen.

Splenectomies are performed for a variety of different reasons and with different degrees of urgency. Most splenectomies are done after a patient has been diagnosed with hypersplenism. Hypersplenism is not a specific disease but a syndrome (group or cluster of symptoms) that may be associated with different disorders. Hypersplenism 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 such specific disorders 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.

Splenectomy always required

There are two diseases for which a splenectomy is the only treatment—primary cancers of the spleen and a blood disorder called hereditary spherocytosis (HS). In HS, the absence of a specific protein in the red blood cell membrane leads to the formation of relatively fragile cells that are easily damaged when they pass through the spleen. The cell destruction does not occur elsewhere in the body and ends when the spleen is removed. HS can appear at any age, even in newborns, although doctors prefer to put off removing the spleen until the child is five to six years old.