This document provides tips and instructions for using a PowerPoint presentation on splenectomy. It recommends freely editing and modifying the presentation. It notes that half the slides are blank except for the title to be used for active learning sessions where the audience provides information before the slide is shown. The presentation can also be used for self-study. The document then provides the PowerPoint presentation on splenectomy, covering introduction and history, indications, complications, prevention strategies and more. It includes tips for accessing the presentation on mobile devices.

1. Tips on using my ppt.
1. You can freely download, edit, modify and put your
name etc.
2. Don’t be concerned about number of slides. Half the
slides are blanks except for the title.
3. First show the blank slides (eg. Aetiology ) > Ask
students what they already know about ethology of
today's topic. > Then show next slide which enumerates
aetiologies.
4. At the end rerun the show – show blank> ask questions >
show next slide.
5. This will be an ACTIVE LEARNING SESSION x
three revisions.
6. Good for self study also.
7. See notes for bibliography.

2. Introduction & History.

3. Introduction & History.
• Splenectomy is indicated to help control or
stage the underlying disease in cases of
splenomegaly.
• After splenectomy one is more susceptible
to infections most dreaded is OPSI.

4. Indications

5. Indications
• Hereditary spherocytosis,
• Immune thrombocytopenia (ITP)
• Autoimmune hemolysis.
• Pathological diagnosis in
lymphoproliferative disorders such as
splenic marginal zone lymphoma or hairy
cell leukemia.
• Chronic, severe hypersplenism.
• In rare cases of reat thrombotic
thrombocytopenic purpura(TTP).

6. Chronic, severe hypersplenism.
•

7. Chronic, severe hypersplenism.
• Hairy cell leukemia
• Felty syndrome
• Primary myelofibrosis(agnogenic myeloid
metaplasia)
• Thalassemia major
• Gaucher disease
• Hemodialysis splenomegaly
• Splenic vein thrombosis
• Not in sickle disease.

8. Postsplenectomy complications

9. Postsplenectomy complications
• Splenic macrophages play a major role in
filtering and phagocytizing bacteria and
parasitized blood cells from the circulation.
In addition, the spleen is a significant
source of antibody production.

10. Postsplenectomy complications
• Leucocytosis
• Thrombocytosis
• Overwhelming post-splenectomy infection
(OPSI) Increased risk of sepsis due to
encapsulated organisms-
• Streptococcus pneumoniae,
• Haemophilus influenzae type B
• Neisseria meningitidis types A and C.

11. Demography

12. Demography
• Approxmately 2% of splenectomized.
• Asplenic children younger than 5 years,
especially infants splenectomized for
trauma, may have an infection rate of
greater than 10%.
• Splenectomy performed for a hematologic
disorder, carry a higher risk than
splenectomy performed as a result of
trauma.

13. Symptoms

14. Symptoms
• begins as a nonspecific, flulike prodrome
that is followed by a rapid evolution to full-
blown bacteremic septic shock—
– Hypotension
– Anuria
– clinical evidence of disseminated intravascular
coagulation
– Waterhouse-Friderichsen syndrome, with
bilateral adrenal hemorrhages noted at autopsy.

15. Prognosis

16. Prognosis
• Despite appropriate antibiotics and
intensive therapeutic intervention, the
overall mortality rate in older published
studies of established cases of OPSI varied
from 50-70%

17. Investigations

18. Investigations
• Laboratory Studies
– Routine
– Special :Blood culture.
• Imaging Studies
• Tissue diagnosis
– Cytology
• FNAC
– Histology

19. Management

20. Management
• Cefotaxime
• IV fluids
• Nor ad infusion.
• Albumin iv.
• Intensive care.

21. Prevention

22. Prevention
• Preventative strategies for OPSI fall into 3
major categories:
1. Education,
2. Immunoprophylaxis,
3. Chemoprophylaxis.

23. Education

24. Education
• Wear a Medi-Alert bracelet and carry a
wallet card explaining their lack of a spleen.
• Notify their physician in the event of an
acute febrile illness, especially if it is
associated with rigors or systemic
symptoms.

25. Immunoprophylaxis:Vaccination

26. Immunoprophylaxis:Vaccination
• Pneumococcal vaccine (Pneumovax 23)
• The pneumococcal vaccine should be
administered at least 2 weeks before an
elective splenectomy.
• As soon as possible after recovery and
before discharge from the hospital or, at the
latest, 24 hours following the procedure.
• Meningitis group A C Y and W-135
vaccine .
• Hemophilus influenza type b conjuugate
vaccine.

27. Chemoprophylaxis.

28. Chemoprophylaxis.
• Antibiotic prophylaxis for asplenic children,
especially for the first 2 years after
splenectomy.
• Preprocedure prophylaxis-- antibiotic
prophylaxis prior to undergoing procedures
associated with a risk of transient or
sustained bacteremia. Antibiotics should
cover encapsulated organisms and
organisms likely to be found at the
operative site.

29. Avoid total splenectomy

30. Avoid total splenectomy
• Observation for Splenic trauma
• Interventional radiology- Embolisation
• Splenorrhaphy
• Partial splenectomy
• Meshing

31. Get this ppt in mobile
1. Download Microsoft
PowerPoint from play
store.
2. Open Google assistant
3. Open Google lens.
4. Scan qr code from
next slide.

32. Get this ppt in mobile

33. Get my ppt collection
• https://www.slideshare.net/drpradeeppande/
edit_my_uploads
• https://www.dropbox.com/sh/x600md3cvj8
5woy/AACVMHuQtvHvl_K8ehc3ltkEa?dl
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• https://www.facebook.com/doctorpradeeppa
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