2) Blood disorders that necessitate splenectomy
As mentioned above, the spleen is the main organ that deals with red cells after they exit their manufacturing plant, the bone marrow. That is why when there are disorders of red cell shape or content, the spleen enlarges to deal with the dysfunctional red cells, and such enlargement can cause clinical complications in 2 forms:
- When the spleen enlarges, it becomes heavier, putting a load on the ligaments attaching it to the surround structures like the diaphragm. This tension causes a dragging pain in the abdomen that can cause significant discomfort to the patient. The pain is usually worse on standing up or sitting and is relieved partially by laying back. The rapid enlargement can also cause the blood supply to be relatively inadequate. This causes splenic infarction which, in turn, causes the splenic capsule to inflame producing the characteristic stitching pain.
- One of the complications of the enlarged spleen is the development of It means that the spleen’s function to eat up cells spirals out of control and it becomes aggressive towards healthy cells, causing deficiencies of red cells, white cells and platelets. This condition can manifest by one or more of the following: anemia, increased susceptibility to infection and easy bruising/bleeding.
Hematological disorders that need or may benefit from splenectomy include:
This is one of the commonest indications of splenectomy. In this disorder, platelets are deficient because they are destroyed via an autoimmune reaction that develops following viral infections. The spleen is not the cause of the condition but is the site in which platelets are destroyed. Its removal ameliorates the platelet deficiency; however, it is only performed in chronic cases that do not respond well for medical therapy -which remains a minority- and is avoided in surgery.