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In most cases, when the spleen is removed for blood disorders (spherocytosis, elliptocytosis, Idiopathic thrombocytopenic purpura (ITP), sickle cell anemia), the spleen is functioning perfectly normally and the abnormalities of the blood are producing the problem.
The normal red cell is disk shaped and as it ages, the internal membranes break down and the cell assumes a spherical shape and is removed by the spleen approximately 100 days after it is created.
In conditions called spherocytosis and elliptocytosis, this change in the cell shape occurs at a much younger age of the cell leading to its premature destruction. This premature destruction results in anemia (low red cell count) and an increased risk of developing gallstones.
The hemoglobin in the broken-down red blood cells is then excreted as bilirubin in the bile from the liver. If the level of bilirubin in the bile is too high, it will result in gallstone production.
In idiopathic thrombocytopenic purpura (ITP),the platelets are often coated with antibody, which has been mistakenly produced by the body's immune system.
This coating of the platelets with antibody leads the spleen to see them as foreign and filter them from the blood leading to excessive destruction.
Some children can develop a life-threatening crisis where blood pools in the spleen, which becomes enlarged.
Before your child has an elective splenectomy, a doctor should administer should vaccines against pneumococcal, Haemophilus influenza and meningococcal organisms.
Current recommendations for children and adults without spleens are to have repeat immunizations every 3 years for children less than 10 years old and every five or six years for people more than 10 years old.
Your child's spleen will be removed by either "open" or laparoscopic methods.
Most children stay in the hospital two to five days after the surgery. While there, your child will be monitored for signs of infection and to make sure the recovery is going well. Your child's doctor may prescribe an antibiotic for when you go home.
There are a few things to watch out for immediately following your child's surgery:
There are also some longer-term complications:
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