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Splenectomy

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13/05/2007

  • Haemorrrhage is the most life-threatening complication and usually occurs in the first 24hrs.
  • Gastric dilatation is uncommon.  Present as nausea, tachycardis, hypotension and signs of sytemic shut down.  Patients will develop a sucussion splash.
  • Pancreatic fistula will present with vomiting secondary to a localised aleus around the DJ flexure.
  • Subphrenic abscess - nause, vomiting, distension, swinging pyrexia, left pleural effusion.
  • Post-splenectomy infection.  The most vulnerable are children and the elderly, patients within the first year after splenectomy and those with haematological malignancy.
  • Increased risk of contracting malaria from travel to areas where it is endemic.


Antibiotic Prophylaxis.

  • Lifelong peniccillin (250mg bd)
  • Urgent hospital admission on development of infective symptoms.
  • PNEUMOCOCCAL vacination every 5 years
  • INFLUENZA vaccinations every year
  • (Haemophilus Influenzae & meningococcal vaccination before or as soon as possible after emergency surgery.

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