$Unique_ID{BRK00679}
$Pretitle{Accidents, Poisoning, and Violence}
$Title{Is It Always Necessary to Remove the Spleen After an Injury?}
$Subject{spleen injury surgery}
$Volume{O-24}
$Log{
The Abdomen*0001501.scf}

Copyright (c) 1991   Tribune Media Services, Inc.


Is It Always Necessary to Remove the Spleen After an Injury?


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QUESTION:  Another player on my high school hockey team suffered an injury to
his spleen, but his doctor repaired it surgically.  My father says that all
injured spleens should be removed.  Is he right?  Is it always necessary to
remove the spleen after an injury?

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ANSWER:  Fathers like the reputation of always being right, but this time
medical practice has moved beyond Dad's knowledge.  Splenectomy (the operation
to remove the spleen) was once done routinely after an injury to the upper
left quadrant of the abdomen where the spleen is located.  Because doctors did
not know what, if any, function was performed by the spleen, they believed it
was not needed.  That belief was substantiated by the fact that the death rate
from injury to the spleen was 90 to 100 percent before 1900, and before
surgical removal of the spleen was used as treatment.  Now, however, doctors
understand that the spleen plays an important role in preventing infection.
In fact, some studies have shown that the death rate due to infection is 58
times greater than the normal population in patients who have had their spleen
removed after injury.  (Post-operative infection only occurs in 0.5 to 1
percent of these patients though).
     Because of the new understanding of the spleen's function, today's
treatment is more conservative when a patient has received a possible injury
to the spleen.  A direct blow to the abdomen, a fall, and car accidents are
common causes of damage to the spleen.  Children especially are at risk; for
them the spleen is the most commonly injured abdominal organ.  Although in
some cases, the extent of injury will make removal of the spleen necessary,
physicians often try to repair the organ surgically, or they may closely
observe the patient and let the body heal itself.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
