What happens when a splenectomy is required?

Written by: Mr Joseph Varghese
Published: | Updated: 13/04/2023
Edited by: Karolyn Judge

The spleen is an important part of the body’s immune system but it’s possible to be removed without problems, especially if it’s causing them. Issues such as a rupture and enlargement may spring to mind when considering splenectomies but infection, cancers and blood disorders can also cause it to be taken out.


Mr Joseph Varghese, leading consultant general surgeon and specialist in upper GI and laparoscopic (keyhole) surgery, provides an informative guide to the splenectomy for people who may need to undergo the procedure.


Close up of a torso of a man wearing a blue shirt, holding the side of his stomach


What is the function of the spleen?

The word spleen comes from ancient Greek. The spleen has an important function in the red blood cells (erythrocytes) and the immune system function. It recycles iron, removes old red blood cells and holds a reserve of blood. This reserve can be valuable in the case of haemorrhagic shock.


The spleen removes bacteria and blood cells via blood and lymph node circulation. It also synthesizes antibodies in its white pulp. The spleen is a centre of activity of the mononuclear phagocyte system and is like a large lymph node. Absence of spleen causes a susceptibility to certain infections. Creation of red blood cells and the ability to produce lymphocytes makes the spleen a hematopoietic organ.


Why would you have your spleen removed?

A splenectomy is performed for a variety of diseases and conditions:


  • Ruptured spleen

This is the most common cause of a splenectomy.


  • Splenic rupture

This could be due to a severe abdominal injury or because of an enlarged spleen (splenomegaly). The result may be life-threatening, causing internal bleeding and haemorrhagic shock.


  • Enlarged spleen

Splenectomy may be done to ease the symptoms of an enlarged spleen, such as pain and fullness of the abdomen.


  • Blood disorder

Blood disorders that may be treated with splenectomy include idiopathic thrombocytopenic purpura (ITP), polycythaemia vera and thalassemia. Other treatments to reduce the symptoms of these disorders are attempted before splenectomy is performed as a final option.


  • Cancer

Cancers that may be treated with splenectomy include:

  • Chronic lymphocytic leukaemia
  • Hodgkin's lymphoma
  • Non-Hodgkin's lymphoma
  • Hairy cell leukaemia


  • Infection

If it doesn’t respond to other treatment, severe infection or the development of a large collection of pus surrounded by inflammation (known as an abscess) may require removal of the spleen if it does not respond to other treatment.


  • Cyst or tumour

If they become large or are difficult to completely remove, noncancerous cysts or tumours inside the spleen may require splenectomy.


  • Diagnosis

Removal of the spleen may occur to help diagnose a condition.


What are the consequences of a post-operative splenectomy?

Long-term risk of infection can occur. After spleen removal, there is a risk of serious or life-threatening infections. It is recommended that patients are vaccinated against pneumonia, influenza, Haemophilus influenzae type b (Hib) and meningococci. It is also recommended that you take preventive antibiotics, especially if you have other conditions that increase your risk of serious infections.


What is life like without a spleen?

Other organs take control of the functions previously performed by the spleen after splenectomy. While you can be active without a spleen, you are at higher risk of getting sick or getting serious infections. The risk is highest shortly after surgery. Recovery from an illness or injury may be more difficult for people without a spleen. It could be a good idea to wear a medical alert bracelet, which indicates you don’t have a spleen.


Can you provide travel advice for people without a spleen?

Patients are advised to take a course of antibiotics if they are travelling abroad. It’s also recommended they check the need for any travel vaccinations. The risk of developing a severe form of malaria is increased for people without a working spleen.


Is life expectancy an issue for people who have had a splenectomy?

The majority of spleens are removed for trauma. The life expectancy is dependent on the other injuries sustained.


In patients with other conditions requiring splenectomy, the life expectancy is dependent on their comorbidities, such as malignancy or leukaemia, etcetera.


Are you concerned about having a splenectomy or experiencing conditions that could lead to one? Mr Varghese can offer his expert service. Visit his Top Doctors profile in order to arrange an appointment with him.

By Mr Joseph Varghese

Mr Joseph Varghese is a leading consultant general surgeon based in Bolton, who specialises in upper GI and laparoscopic (keyhole) surgery with a particular interest in reflux, gallbladder and hernias. He also specialises in endoscopies, colonoscopies and endoscopic removal of gallstones from the bile duct (ERCP).

Mr Varghese studied medicine at Mangalore University, India before relocating to the UK to complete his basic higher surgical training in the north west of Scotland on Aberdeen’s surgical training programme. He was awarded fellowships from the Royal College of Surgeons, Edinburgh and became a consultant in 2005. As part of his training, he completed several specialist training programmes in laparoscopy at esteemed centres in Paris. He has also achieved JAG accreditation as an endoscopist (gastroscopy, colonoscopy and ERCP). Mr Varghese has been based in Bolton since 2006, specialising in upper gastrointestinal as well as general surgery. He is the clinical lead for upper GI and hepatobiliary cancers and endoscopy training at his NHS base. He sees private patients at The Beaumont Hospital

Mr Varghese is a leading educator in his field and has undertaken numerous teaching positions, including as a tutor and director of the Royal College of Surgeons' intermediate laparoscopic skills course. He is widely published in peer reviewed journals and regularly presents both at a national and international level. He maintains a strong interest in research, audit and training.

Mr Varghese is a member of the Clinical Guidance Development Group for NICE guidance on upper GI haemorrhage. Throughout various stages in his esteemed career, Mr Varghese has served as a Major in the Royal Army Medical Services

View Profile

Overall assessment of their patients

  • Related procedures
  • Nutrition
    Food intolerance test
    Eating disorders
    Balloon enteroscopy
    pH monitoring
    Stomach reduction
    Gastric balloon
    Colon cleanse
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.