INTRODUCTION Figure 1: The spleen1
The spleen is an organ that can be found in the human body deep to ribs 9-11 on the left hand side in the midclavicular line. It is known as a secondary lymphoid organ and the largest organ involved in lymphatics1.It is made up of two parts: white pulp which is responsible for the maturation of lymphatic cells as well as blood cells; and the red pulp which is responsible for filtration and the removal of old blood cells2.
THE SPLEEN HAS THREE MAIN ACTIONS3:
1. Sequestration: The reticular meshwork of the cords in the red pulp trap cells by creating adhesion to them and then filter out the senescent or poorly formed redblood cells
2. Phagocytosis: Irreversible uptake of antibody-coated particulates and other foreign matter in preparation for antigen presentation. Hence a patient who has undergone a splenectomy will be prone to bacterial sepsis from encapsulated organisms. Phagocytosis can also be performed on antibody platelets and red blood cells, essentially trapping and destroying them, in conditions such as Immune Thrombocytopenia and hemolytic anemia and that can be an indication for a splenectomy.
3.…show more content… Pitting: Removal of particulates of circulating red blood cells like Howell-Jolly bodies which are nuclear remnants and they can be seen in red blood cells after a splenectomy.
To understand the indications that lead up to a patient being splenectomized, one must familiarize themselves with the concept; Therefore, a splenectomy has been defined as being an operation in which the entire spleen is removed, however a part of the spleen can be left behind and that is then called a partial splenectomy4. In a small portion of the population there has been incidences of a secondary or rather accessory spleen demonstrated which can take over the function of the removed spleen. This accessory spleen is much smaller but with time can grow4.
WHO NEEDS A SPLENECTOMY?
The indications of a splenectomy are as