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Last updated: 11/24/2009
In the United States, splenomegaly affects as many as 30% of full-term newborns and about 10% of healthy children. Approximately 3% of healthy first-year college students also have spleens that are large enough to be felt when a doctor palpates the...
abdomen. Some specific causes of splenomegaly are more common in certain racial or ethnic groups. For example, splenomegaly is a common complication of sickle cell disease in patients of African or Mediterranean ancestry. In other parts of the world, splenomegaly is frequently caused by malaria, schistosomiasis, and other infections in areas where these diseases are endemic.
Hereditary spherocytosis (HS) is a disorder is most common in people of northern European descent but has been found in all races. A family history of HS increases the risk of developing this disorder.
Immune thrombocytopenic purpura (ITP) is much more common in children, with male and female children being equally afflicted. Female predominance begins at puberty and continues in adult patients. Overall, 70% of patients with ITP are female; 72% of women diagnosed with ITP are over 40 years old.
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The spleen is one of the most misunderstood organs in the body. This narrated animation describes both the anatomy and function (physiology) of the spleen.
There are two options for accessing the spleen for a splenectomy (A, 1 and 2). After the abdomen is entered, the spleen is located, and the artery leading to it is tied off (B). The ligament connecting the stomach and spleen is cut (C), as is the ligament connecting the spleen and colon (D). This frees the spleen for removal (E). (Illustration by GGS Inc.)
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A splenectomy is a procedure that involves the removal of the spleen by operative means.
Vaccination for pneumococcus, H. influenza and meningococcus should be given pre-operatively if possible. In general, spleens are removed by laparoscopy (minimal access surgery) when the spleen is not too large and when the procedure is elective. It is performed by open surgery for trauma or large spleens. Both methods are major surgeries, and are performed under general anesthesia. The spleen is located and disconnected from its arteries. The ligaments holding the spleen in place are dissected and the spleen is removed. When indicated a drain is left in place and the incision(s) is closed. If necessary, tissue samples are sent to a laboratory for analysis.
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