A splenectomy is surgery to remove the entire spleen, a delicate, fist-sized organ that sits under the left rib cage near the stomach. The spleen is an important part of the body's defense (immune) system. It contains special white blood cells that destroy bacteria and help the body fight infections when you are sick. It also makes red blood cells and helps remove, or filter, old ones from the body's circulation.
If only part of the spleen is removed, the procedure is called a partial splenectomy.
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Unlike some other organs, like the liver, the spleen does not grow back (regenerate) after it is removed.
Up to 30% of people have a second spleen (called an accessory spleen). These are usually very small, but may grow and function when the main spleen is removed. Rarely, a piece of the spleen may break off with trauma, such as after a car accident. If the spleen is removed, this piece can grow and function.
Who Needs a Splenectomy?
You may need to have your spleen removed if you have an injury that damages the organ, causing its covering to break open, or rupture. A ruptured spleen can lead to life-threatening internal bleeding. Common injury-related causes of a ruptured spleen include car accidents and severe blows to the abdomen during contact sports, such as football or hockey.
A splenectomy may also be recommended if you have cancer involving the spleen or certain diseases that affect blood cells. Certain conditions can cause the spleen to swell, making the organ more fragile and susceptible to rupture. In some cases, an illness, such as severe lupus and sickle cell disease, can cause the spleen to shrivel up and stop functioning. This is called an auto-splenectomy.
The most common disease-related reason for a spleen removal is a blood disorder called idiopathic thrombocytopenic purpura (ITP). This is an autoimmune condition in which antibodies target blood platelets. Platelets are needed to help blood to clot, so a person with ITP is at risk for bleeding. The spleen is involved in making these antibodies and removing the platelets from the blood. Removing the spleen can be done to help treat the condition.
Other common reasons a person may need a spleen removal include:
Hereditary elliptocytosis (ovalocytosis)
Hereditary nonspherocytic hemolytic anemia
Thalassemia (Mediterranean anemia)
Blood vessel problems:
Aneurysm in the spleen's artery
Blood clot in the spleen's blood vessels
Leukemia, a blood cancer that affects cells that help the body fight infections.
Certain types of lymphoma, a cancer that affects cells that help the body fight infections.
Cyst or abscess (collection of pus) in the spleen
Before a Splenectomy
If your doctor thinks you have a ruptured spleen and you have signs of massive internal bleeding or unstable vital signs, such as low blood pressure, you will likely have spleen surgery right away.