2. • Haemorrhage—mainly from short gastric vessels.
• Re-exploration and control of bleeding is needed or endoscopic clipping.
• Haematemesis due to mucosal congestion following ligation of short gastric
vessels.
• Left sided pleural effusion and left basal atelectasis (left lower lobe atelectasis
is the commonest complication) (30%).
• Minimized or avoided by incentive spirometry and chest physiotherapy.
• Left subphrenic abscess.
• Prompt diagnosis and Percutaneous drainage with catheter placement
• Haematologic changes: Rise in WBC and platelet count, rise in abnormal
RBCs and RBC bodies.Postoperative thrombocytosis (plt>1*10^6/ml)
• Prophylactic aspirin, Platelet apheresis or Anticoagulants
3. • Infection — Post-splenectomy septicaemia, OPSI within 1st 2-3 years—most
dangerous. Due to lose of splenic macrophages, lose of reticuloendothelial
screening function. This system is particularly suited to the removal of
encapsulated bacteria, whose polysaccharide coating is a natural defense
against opsonization. Infections with protozoa that invade the red blood cell
occur more frequently in splenectomized individuals than in normal hosts. In
the absence of the spleen, elimination of these pathogens from the
bloodstream falls solely to the liver, a process that has been demonstrated to
be less effective.
• Managed by antibiotic prophylaxis, appropriate and timely
immunization, education and prompt treatment of infection.
4. • Gastric fistulas (may result from damage to the greater curvature of the stomach
during ligation of the short gastric vessels).
• Damage to the tail of the pancreas may result in pancreatitis, a localised abscess or
a pancreatic fistula.
Conservative or surgical repair
• Left sided colonic injury.
• Gastric Dilatation the laxity of supporting ligaments makes the stomach more prone
to rotation and consequently leading to volvulus. Splenectomy for massive
splenomegaly requires division of gastric ligaments and the residual dead space
provide room for gastric rotation.
• Portal vein thrombosis can occur.
• DVT as a late sequel after splenectomy is often dangerous. Risk is 4 times more
than in non-splenectomised people and so also pulmonary embolism.
• It is better to put them on long-term small dose of aspirin to reduce the
incidence of thromboembolism.
