Splenectomy: Can You Live Without a Spleen

The spleen is a small organ located under the rib cage and close to the stomach (left upper abdomen). Functions of the spleen in the body include recycling old red blood cells and fighting certain infections. 

The spleen plays a crucial role in the body, but some people are born without it. Some medical conditions can also call for its removal. You can live without a spleen, but how is it like to live without a spleen?

Reasons for splenectomy

Some people are born without a spleen, while others have it removed for medical reasons. Asplenia refers to the absence of the spleen or the normal spleen function. Several conditions might call for the removal of your spleen. Here are some of the most common reasons:

1. Injury 

Injuries to the spleen might call for splenectomy. A car accident, an assault, or a blow to the abdomen when playing football or hockey can rupture the spleen and cause internal bleeding. Symptoms of a ruptured spleen include nausea and severe pain on the left side of the abdomen. 

You may also feel pain in the left shoulder and experience painful breathing. Excessive internal bleeding as a result of spleen rapture can also cause low blood pressure. Low blood pressure can cause the feeling of lightheadedness, blurred vision, fainting, nausea, restlessness, and confusion. If you are experiencing any of the above signs of low blood pressure, you should visit the nearest hospital as soon as possible.

Ruptured spleen treatment depends on the severity of the injury. If the patient is critically ill and has lost a large amount of blood, emergency surgery to remove the spleen is the best option. Minor spleen injuries can heal by themselves and may not require the removal of the entire spleen. A surgeon can also repair an injured spleen to stop internal bleeding. Whether to remove or repair a ruptured spleen depends on the nature of the injury.

2. Cancer

Spleen cancer is rare. It can either be primary or secondary. Primary spleen cancer starts in the spleen, while secondary spleen cancer spreads to the spleen from another organ or tissue in the body. 

Lymphoma is the most common type of spleen cancer. It is the cancer of the lymphatic system that spreads to the spleen. Blood cancer (leukemia) can also spread to the spleen. Leukemia cells can also gather and build up in this organ. Cancers of the breast, lungs, and skin can also spread to the spleen.

Some of the common symptoms of spleen cancer include:

  • Frequent infections
  • Low red blood cells count
  • Fatigue
  • Shortness of breath
  • Chest pain
  • Weight loss

Spleen cancer treatment options include chemotherapy, radiation therapy, and splenectomy. Your doctor can also recommend a human-made antibody known as rituximab to treat spleen cancer. Rituximab is almosts as effective as spleen removal.

3. Blood disorders

Some types of blood disorders may call for the removal of the spleen. Some of these blood disorders include:

  • sickle cell anemia
  • polycythemia vera
  • hemolytic anemia
  • idiopathic thrombocytopenic purpura (ITP)

Spleen removal is not the only treatment option for the above blood disorders. It is done only when a condition is not responding to other available treatment options. 

4. Enlarged spleen

Bacterial infections like syphilis and viral infections like mononucleosis can cause enlargement of the spleen. An enlarged spleen can be trapping a high amount of platelets and red blood cells. That means that the spleen starts destroying healthy blood cells. When this happens, the number of healthy platelets and red blood cells in the bloodstream reduces. The spleen then becomes clogged and starts enlarging. An enlarged spleen can cause infection, anemia, and excessive bleeding. The spleen may even rupture and end up causing a more life-threatening condition. People with an enlarged spleen are at high risk of spleen rupture. 

Spleen removal surgery

There are two types of spleen removal surgeries: open and laparoscopic splenectomy. In an open splenectomy, the surgeon cut down the center of the patient’s abdomen. The surgeon then moves aside the tissues that are above the spleen and then removes the spleen. After removing the spleen, the incision is then closed with stitches. Surgeons prefer open splenectomy when the patient has a ruptured spleen. 

Laparoscopic splenectomy is less invasive than an open splenectomy. It is quick and has a fast recovery. In this type of surgery, the surgeon makes a small cut on the patient’s abdomen and then uses a small camera to project the video of the spleen on a monitor. The surgeon then uses small tools to remove the spleen and then stitch up the incisions. 

Spleen removal risks

Splenectomy is major surgery. Some of the risks that are common to spleen surgeries include:

  • Stroke or heart attack
  • Excessive blood loss
  • Blood clots
  • Infection
  • Breathing difficulties

There are also other risks are associated with a spleen removal surgery in particular. 

  • Blood clots in the vein that moves blood to the liver
  • Collapsed lungs
  • Hernia at the incision area
  • Damages to the organs near the spleen

What happens to the body after the removal of the spleen

Spleen is part of the immune system. It helps fight infections. Its removal weakens the body’s defense mechanism. Having a weak defense mechanism means that there are higher chances of contracting infections like pneumonia and meningitis. Splenectomy patients and babies born without a spleen should get vaccines against pneumonia, meningococci, influenza, and Haemophilus influenza type b (Hib). Your doctor may also recommend preventative antibiotics, especially if you have another health condition that makes you more susceptible to a life-threatening infection. 

After a splenectomy surgery, organs like the liver, lymph nodes, and bone marrow take over the spleen functions. That is why it is possible to live without a spleen. It is also the reason why asplenia babies still have a chance in life.

The liver is among the five most important organs in the body. Unlike the spleen, you can’t live without the liver. There is no other body organ that performs as many functions as the liver. It has about three hundred roles and also helps other organs like the spleen do their job. After spleen failure or splenectomy, the liver takes over some of the functions of the spleen.

Polysplenia

Some people have a second spleen known as the accessory spleen. Approximately 10 percent of the population are born with an accessory spleen. The second spleen is usually very small (has a diameter of one centimeter) and does not cause any harm. The accessory spleen can start growing after splenectomy. During splenectomy, doctors only remove the raptured or sick spleen. They don’t touch the secondary spleen if it is functioning well.

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