Splenectomy

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• removal of the spleen
• red cell count remains the same
  • Howell-Jolly bodies seen in red cells

Indications

• rupture / severe trauma
• splenic cysts
• tumours
  • splenic
  • adjacent
• Idiopathic Thrombocytopenic Purpura
• Autoimmune haemolysis
• Staging of Hodgkin's Disease
• Hypersplenism

Complications

• increased risk of Thrombosis
  • transient increase in Platelets
• lifelong risk of infections
  • vaccines
    • Streptococcus pneumoniae  >2 week pre-op
      • repeat 5-10 years
    • Haemophilus Influenzae
    • Neisseria meningitidis
  • prophylactic antibiotics (Phenoxymethylpenicillin)
    • up to 16 years old
    • at least 2 years post-splenectomy
  • 'Stand by' Amoxicillin if signs of infection
  • Risk of severe Malaria

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