If you are having an overwhelming feeling of fullness despite only eating small portions of food, accompanied by unexplained pain in the upper-left quadrant of your abdomen, make an appointment with your doctor right away. After careful evaluation, which will usually include some imaging tests and blood work, you may be diagnosed with an enlarged spleen. If this is the case, you will be scheduled for spleen-removal surgery in the hospital that your doctor is affiliated with.
The spleen of a healthy adult is approximately the size of a closed fist and is located on the left side of the abdomen, just below the ribs. According to the Journal of the American Medical Association (JAMA), the primary function of the spleen is to fight bacteria. However, if a splenectomy (removal of the spleen) is necessary because of disease, the other organs in the body will take over the bacteria-fighting process. The spleen also serves as a filter for old and damaged red blood cells.
One of the most worrisome side effects of spleen removal is the development of sepsis. Since the body has formally relied on the spleen to filter out bad bacteria, there is an increased chance of infection after it has been removed. For this reason patients are often placed on a two-year regimen of antibiotics to combat the sepsis side effect. According to the University of California in San Francisco, children are the most at-risk group of individuals to develop sepsis after spleen removal. The threat of sepsis decreases in the years that follow surgery.
The spleen is located within very close proximity to the lung on the left side of the abdomen. Lake Norman Surgical Associates of Pennsylvania explains that there is a risk of lung collapse after spleen removal surgery along with an increased risk of fluid in the lungs and pneumonia. Lung collapse is treatable with physical and respiratory therapy. Chest infection and pneumonia are often treated in combination with antibiotic therapy.
Thrombocytosis is a condition that sometimes occurs after spleen-removal surgery. In the book "Platelets in Thrombotic and Non-Thrombotic Disorders: Pathophysiology," author Paolo Gresele explains that the spleen holds approximately one-third of the blood platelets that are in the human body. So, it stands to reason that the removal of the spleen would prompt an increase in blood-platelet circulation throughout the body. However, the lab results for some patients that have had their spleens removed show an increased platelet level in excess of 50 percent. The thrombocytosis condition can persist for upward of two weeks, increasing the patient's risk of life-threatening blood clots.
Blood loss is a side effect and major complication of spleen-removal surgery. An enlarged spleen that is overfilled with red blood cells poses a risk of rupture. If the rupture happens before surgery, the result can be life-threatening. Under these circumstances, an emergency splenectomy is warranted. But sometimes the spleen can rupture during surgery, causing severe blood loss and hemorrhage. For this reason, laparoscopic surgery has taken the place of open spleen-removal surgery whenever possible. In the book "Complications in Surgery and Trauma," author Stephen M. Cohen explains that patients that undergo a spleen removal that is performed laparoscopically experience significantly less blood loss than those patients who undergo open splenectomies. Laparoscopic spleen removal also requires a shorter hospital stay.