Complications of splenectomy
Any surgery has a percentage of complications even in the hands of the most expert of surgeons. They depend on several factors including the type of surgery, its site and the general condition of the patient. The expertise of the surgeon also plays a role in the rate of complications, but it is far from being the only factor. The most common complications of splenectomy include:
Bleeding: Bleeding is one of the most common complication of all surgeries. It can occur on the operating table, following wound closure or even after 48 hours after the surgery. Bleeding is the leading cause of death in splenectomies.
Pancreatic injury: The pancreas is in close proximity to the spleen and its tail can be injured in splenic surgery. The problem isn’t related to the pancreas specifically but to the release of pancreatic juice into the abdominal cavity. Pancreatic juice is extremely strong against fats and protein and can digest the abdominal cavity organs including arteries which can cause severe hemorrhage, for that reason if such injury is detected or suspected during the operation, a drain is placed to drain the pancreatic juice.
Infection: In the recent past, the role of the spleen in immunity was greatly underrated, but the removal of the spleen significantly affects immunity and that is why it is avoided in children except in very few instances. One of the life-threatening complications of splenectomy is the development of OIS or overwhelming infection syndrome. This syndrome is rare to develop but if it does, up to 1 in every 2 patients can die from it.
Portal vein thrombosis: The portal vein is the main venous drainage of the gastrointestinal tract. It is formed by the union of the inferior mesenteric artery and the splenic artery. During surgery, mediators are released from the injured tissue that cause coagulation to commence. These mediators can cause a blood clot to form in the portal vein. The condition is manageable and avoidable by effective anticoagulation which is given routinely.