The Spleen and Splenectomy Flashcards
When is a mass in the LUQ a spleen:
- Where does it usually grow towards?
- What about percussion?
- What happens during inspiration?
- How do you know it is not the left kidney becoming enlarged by malignancy?
RIF
Dull percussion
It moves down
You can’t get your hand above it on palpation
What imaging is used for the spleen?
USS or CT
What is the role of the spleen?
The spleen has some important functions: it fights to invade germs in the blood (the spleen contains infection-fighting white blood cells) it controls the level of blood cells (white blood cells, red blood cells and platelets) it filters the blood and removes any old or damaged red blood cells.
Splenectomy:
What are the main indications?
What is the main problem post-splenectomy and why?
Trauma
Hypersplenism
Autoimmune haemolysis
ETC.
Increased risk from infection because the spleen contains macrophages which filter and phagocytose bacteria.
Infections post-splenectomy:
What immunisations can be given to reduce this?
What is needed for life?
What can be worn to alert medical staff?
What advice can be given to those travelling abroad where malaria is prevalent?
Pneumococcal vaccine
Haemophilus influenzae
Meningococcal vaccination
Annual influenza
Life long oral antibiotics - phenoxymethylpenicillin
Pendants
Bracelets
Patient held cards
Use meticulous prophylaxis with nets, repellents and medication
