After a Spenectomy: Follow-on Care

Prompted by a blog below, Mary writes: "I had Hodgkins Stage 2A and was given 6 cycles of ABVD finishing last October. I only have the odd occasion of numbness in one finger tip. Unfortunately my sister who had stage 4B and a splenectomy as a 17 year old died when aged 34. She was not given any medication and got a pneumococcal infection which gave her septicaemia after being bitten by a pet rabbit. She had been so well for so many years and had three children. We thought she had flu. Afterwards we heard that other people had vaccinations and were on constant antibiotics after having a splenectomy even people who had not had cancer or chemotherapy. We felt very let down by our British National Health Service."



Spenectomy is not normally done in lymphoma staging and treatment anymore. But for those who do have the procedure, care must be taken. From Health A to Z:



Aftercare



Immediately following surgery, patients should follow instructions and take all medications intended to prevent infection. Blood transfusions may be indicated for some patients to replace defective blood cells. The most important part of aftercare, however, is long-term caution regarding vulnerability to infection. Patients should see their doctor at once if they have a fever or any other sign of infection, and avoid travel to areas where exposure to malaria or similar diseases is likely. Children with splenectomies may be kept on antibiotic therapy until they are 16 years old. All patients can be given a booster dose of pneumococcal vaccine five to 10 years after splenectomy.



Risks

The chief risk following splenectomy is overwhelming bacterial infection, or postsplenectomy sepsis. This vulnerability results from the body's decreased ability to clear bacteria from the blood, and lowered levels of a protein in blood plasma that helps to fight viruses (immunoglobulin M). The risk of dying from infection after splenectomy is highest in children, especially in the first two years after surgery. The risk of postsplenectomy sepsis can be reduced by vaccinations before the operation. Some doctors also recommend a two-year course of penicillin following splenectomy or long-term treatment with ampicillin.

Other risks following splenectomy include inflammation of the pancreas and collapse of the lungs. In some cases, splenectomy does not address the underlying causes of splenomegaly or other conditions. Excessive bleeding after the operation is an additional possible complication, particularly for ITP patients. Infection immediately following surgery may also occur.