🧹 Filtration: Removes old or damaged red blood cells.
🛡️ Immune Response: Produces lymphocytes, traps pathogens, and facilitates antibody production.
🩺 Blood Storage: Reservoir for red blood cells and platelets, released during bleeding.
♻️ Iron Recycling: Recycles iron from haemoglobin breakdown.
👶 Fetal Haematopoiesis: Produces red and white blood cells before birth.

📋 Indications for Splenectomy

Cause	Clinical Indications	Post-Operative Guidance
🚑 Trauma	Rupture from blunt trauma (e.g., RTC, sports).	Haemorrhage monitoring, vaccines, infection risk counselling.
🧬 Haematological Disorders	Hereditary spherocytosis, autoimmune haemolytic anaemia, ITP, thalassaemia, sickle cell (sequestration crisis).	Vaccines, prophylactic antibiotics, lifelong infection awareness.
🦠 Infective	Splenic abscess, granulomatous disease (TB, sarcoid).	Vaccines, antibiotic prophylaxis, monitor recurrence.
🎗️ Splenic Neoplasms	Lymphoma, splenic angiosarcoma, metastases.	Oncology follow-up, infection prevention, adjunctive chemo/radiotherapy if indicated.
🫀 Portal Hypertension	Hypersplenism with cytopenias.	Treat underlying cause, hepatology follow-up, infection prevention.
🎯 Immune Thrombocytopenic Purpura (ITP)	Refractory ITP unresponsive to steroids/IVIg.	Monitor platelets, vaccines, thrombosis risk education.
⚠️ Hypersplenism	Pancytopenia secondary to splenic overactivity.	Regular blood count monitoring, post-splenectomy prophylaxis.
🫧 Cysts & Benign Tumours	Large/symptomatic cysts or benign lesions with rupture risk.	Follow-up imaging, standard infection prophylaxis.
🩸 Sickle Cell Disease	Sequestration crisis, functional asplenia (auto-infarction).	Vaccines, prophylaxis, consider hydroxyurea, infection counselling.

🛡️ Post-Splenectomy Care (UK Guidance)

Patients without a spleen are at high risk of overwhelming infection, especially with encapsulated bacteria (Strep pneumoniae, Neisseria meningitidis, Haemophilus influenzae). Mortality can occur within hours - prevention is vital.

💉 Vaccinations

Pneumococcal: PCV13 → then PPV23 (8 weeks later). Booster PPV23 every 5 years.
Hib: One-off dose if not previously given.
Meningococcal: MenACWY + MenB. MenACWY booster every 5 years.
Flu: Annual influenza vaccine.

💊 Antibiotic Prophylaxis

Lifelong penicillin V recommended. If allergic → macrolide alternative.
Emergency antibiotics: Supply for immediate use (e.g., amoxicillin or ciprofloxacin) at first fever if care is not rapidly available.

📢 Patient Education

Carry medical alert card/bracelet.
Seek urgent care for fever or sepsis symptoms.
Travel: Malaria prophylaxis if visiting endemic areas.

📈 Long-Term Follow-Up

Ensure lifelong vaccination updates.
Be aware of thrombosis risk post-splenectomy - consider aspirin or anticoagulation in high-risk patients.
Regular review for infection prevention and haematological health.

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Splenectomy

🩸 Basic Functions of the Spleen