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Treatments and drugs
By Mayo Clinic staffIf an enlarged spleen causes serious complications or the underlying problem can't be identified or treated, surgical removal of your spleen (splenectomy) may be an option. In fact, in chronic or critical cases, surgery may offer the best hope for recovery.
But elective spleen removal requires careful consideration. You can live an active life without a spleen, but you're more likely to contract serious or even life-threatening infections, including overwhelming post-splenectomy infection, which can occur soon after the operation. Sometimes, radiation can shrink your spleen so that you can avoid surgery.
Reducing infection risk after surgery
If you do have your spleen removed, certain steps can help reduce your risk of infection, including:
- A series of vaccinations both before and after the splenectomy. These include the pneumococcal (Pneumovax), meningococcal and haemophilus influenzae type b (Hib) vaccines, which protect against pneumonia, meningitis, and infections of the blood, bones and joints.
- Taking penicillin or other antibiotics after your operation and anytime you or your doctor suspects the possibility of an infection.
- Avoiding travel to parts of the world where diseases such as malaria are endemic.
- Pozo AL, et al. Splenomegaly: Investigation, diagnosis and management. Blood Reviews. 2009;23:105.
- Enlarged spleen. The Merck Manuals: Home Edition for Patients and Caregivers. http://www.merck.com/mmhe/sec14/ch179/ch179b.html. Accessed Sept. 15, 2010.
- Patient information for laparoscopic spleen removal (splenectomy) from SAGES. Society of American Gastrointestinal and Endoscopic Surgeons. http://www.sages.org/sagespublication.php?doc=PI12. Accessed Sept. 15, 2010.
- Henry PH, et al. Enlargement of lymph nodes and spleen. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aid=2875326. Accessed Sept. 15, 2010.
- Brender E, et al. The spleen. Journal of the American Medical Association. 2005;294:2660.
- Armitage JO. Approach to the patient with lymphadenopathy and splenomegaly. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/218749248-3/0/1492/651.html?tocnode=54619609&fromURL=651.html#4-u1.0-B978-1-4160-2805-5..50179-8_7809. Accessed Sept. 15, 2010.
- Splenomegaly. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec11/ch138/ch138b.html. Accessed Sept. 15, 2010.
- Centers for Disease Control and Prevention, et al. Recommended adult immunization schedule - United States, 2010. MMWR. 2010;59:1. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5901a5.htm. Accessed Sept. 15, 2010.
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