Splenectomy in Children

A splenectomy is the surgical removal of a diseased, injured, or mal-functioning spleen, due in most cases to blood disorders.

The spleen is an organ located in the left upper quadrant of the abdomen. As an integral part of the immune system, one of the main functions of the spleen is to fight infection by filtering blood and producing the body’s defenses.

There are several conditions for which the spleen may need to be removed in a child. However, each child’s situation is unique. Parents and caregivers are reminded that many children with these conditions do not require a splenectomy. Among those conditions are the following:

• Congenital hemolytic anemias, which include hereditary spherocytosis, sickle cell anemia and various thalassemias (such as alpha thalassemia or beta thalassemia) where the spleen removes red blood cells too quickly
• Idiopathic thrombocytopenic purpura (ITP) where the spleen removes platelets, which are responsible for clotting the blood
• Splenic cysts
• Tumors
• Injury due to bleeding

Typically, children are referred to a pediatric surgeon for a splenectomy by their primary care physician or hematologist. Rarely is the procedure an emergency. It can usually be scheduled electively after an appointment with a surgeon at Children’s Hospital of Philadelphia (CHOP).

Certain vaccinations are required prior to undergoing a splenectomy, to ensure your child has adequate immunity. These may include vaccines against pneumococcal, haemophilus influenza B and meningococcal organisms. Vaccines are generally given at least two weeks prior to surgery.

Your child’s splenectomy surgery will be performed at the main hospital in Philadelphia. Your child will be cared for by multiple specialists, including a pediatric surgeon, anesthesiologist, and nurse practitioner.

Your child is placed under general anesthesia. The procedure to remove the spleen is often performed laparoscopically, with four tiny incisions, when possible. A laparoscope is a thin, flexible tube with a light and camera that guides the surgeon during the minimally invasive procedure, which can last several hours.

Once the spleen is removed, any incisions are closed with surgical waterproof glue. All sutures are internal and dissolvable.

Most children go home from the hospital the day after having their spleen removed. Before a child is discharged, they must be eating without difficulty, and be comfortable on oral pain medications only.

The majority of patients, depending on their age, will be discharged on antibiotic prophylaxis for at least one year, and possibly longer.

At home, your child will have to refrain from sports and other physical activities for a few weeks. Otherwise, there are no major restrictions. A school-aged child will be able to return to school.

In coordination with the dedicated clinicians in CHOP’s Division of Hematology, our world class multidisciplinary team works together to provide your child with the highest quality and most advanced care, delivered with compassion, integrity and respect. CHOP is consistently ranked among the best in the nation by U.S. News & World Report’s annual survey of the nation’s Best Children’s Hospitals.

Helpful resources to help prepare your child for surgery:

• Preparing your child for surgery
• Preparing your preschooler for surgery
• Preparing your toddler for surgery