Hyposplenism/Splenectomy

Question 1

What are some causes of hyposplenism

Answer 1

splenectomy

sickle cell

coeliac , dermatitis herpertiformis

Graves

SLE

Amyloid

Question 2

What are some diagnostic features of hyposplenism

Answer 2

Howell- Jolly bodies

Siderocytes

Question 3

What is the gold standard investigation for hyposplenism

Answer 3

Radionucleotide labelled red cell scan

Question 4

What is the management for post splenectomy

Answer 4

Pneumococcal, Haemophilus type B and meningococcal type C vaccinations
- 2 weeks before/after procedure

Annual influenza vaccination

Antibiotic prophylaxis for post splenectomy sepsis
- Penicillin V - 500mg BD
-Amoxicillin - 250mg BD

Question 5

What are some surgical indications for a splenectomy

Answer 5

Trauma

Spontaneous rupture-EBV

hypersplenism - hereditary spherocytosis or elliptocytosis

Malignancy

Splenic cystss, abscesses, hydatid cysts

Question 6

What are some complications associated with a splenectomy

Answer 6

Haemorrhage

Pancreatic fistula

Thrombocytosis - prophylactic aspirin

Encapsulated bacteria infection

Question 7

What is post splenectomy sepsis

Answer 7

typically occurs with encapsulated organisms

opsonization occurs but then the bacteria are not recognised

can be from dog bites