General and Gastrointestinal Surgery

Is there any risk to not having a spleen?

Yes. The spleen is an important organ in preventing serious, overwhelming infection by gram positive, encapsulated bacteria, like pneumococcus, meningococcus and hemophilus, that are often lethal in children. In addition, it serves as the body's filter for a variety of particles that are present in the blood. Infection occurring after splenectomy was coined overwhelming postsplenectomy infection (OPSI) and until the 1980s was though to only occur in children. Today, it is recognized that OPSI can occur in both children and adults.

Fortunately, the risk of OPSI is very small. It is estimated to occur in 0.6% of adults who have had a splenectomy and 3% of children. This incidence may be higher if the reason for removing the spleen was for a disease of the spleen rather than for injury. Because the incidence is significantly higher in children, splenectomy is not performed unless absolutely necessary until adulthood. Furthermore, every effort is made during surgery for injuries to the spleen to preserve at least a portion of it.

Reducing the Risk

Here are some main ways to prevent OPSI:

  • Undergo vaccination against pneumococcus and meningococcus prior to splenectomy when possible. While this is not possible when the need for splenectomy arises from an emergency, such as a car accident, it is feasible in all elective splenectomies. Although vaccination is not proven to reduce OPSI, it is believed that this will work. It can not eliminate the risk, however, because there are varieties of these bacteria that are not covered by the vaccination.
  • Take penicillin or erythromycin as soon as a fever (greater than 100º F) or symptoms of a cold- or flu-like illness develops. This should prevent the infection from getting out of control. 
  • Immediately call your physician and let him or her know.  This will help to prevent the infection from getting out of control. 
  • Wear a Medic Alert bracelet.