Which is the most common early complication following splenectomy?
Infections, particularly pulmonary and abdominal sepsis, constitute the majority of the complications. The mortality rate from postoperative sepsis is substantial. Atelectasis, pancreatitis/fistula, pulmonary embolism and bleeding at the operative site are also relatively common occurrences following splenic removal.
Do splenectomy patients need prophylactic antibiotics?
Patients who have had a splenectomy following trauma should continue antibiotic prophylaxis for a minimum of two years after surgery. Consider stopping antibiotic prophylaxis at this time if appropriately counselled.
Are antibiotics needed after splenectomy?
Most guidelines recommend an initial period of daily antibiotic use after splenectomy, and consideration for lifelong use based on risk for infection. In addition to the use of daily antibiotics, splenectomized individuals are recommended to carry their own supply of high-dose antibiotics in case of emergency.
What are the complications after splenectomy?
Splenectomy Complications
- Blood clot in the vein that carries blood to the liver.
- Hernia at the incision site.
- Infection at the incision site.
- Inflammation of the pancreas (pancreatitis)
- Lung collapse.
- Injury to the pancreas, stomach, and colon.
Why does splenectomy increased risk of infection?
Splenectomy may be followed by severe systemic infection because such surgery removes the splenic macrophages that filter and phagocytose bacteria and other bloodborne pathogens. Overwhelming post-splenectomy infection (OPSI), as this complication is called, is uncommon but has high mortality.
What is post-splenectomy sepsis?
The major long-term complication of splenectomy is OPSI, also known as post-splenectomy sepsis syndrome, which is defined as a generalized non-specific flu-like prodrome followed by rapid deterioration to full-blown fulminant septic shock within 24-48 hours of the onset [9].
Why do you need antibiotics after splenectomy?
All patients should be offered lifelong antibiotic prophylaxis. The increased risk of infection in patients with hyposplenism is life long, but is highest early after splenectomy, the biggest risk being from pneumococcal infection.
What antibiotics treat splenectomy?
4.3 Antibiotics Cases of fulminant infection have been reported more than 20 years after splenectomy. Low risk patients should be counselled as to the risks and benefits of prophylaxis, particularly where adherence is an issue. The antibiotic of choice is penicillin V (phenoxymethylpenicillin).
Why do you need to take penicillin after a splenectomy?
Splenectomized patients are at risk of overwhelming infection and are advised to take life-long prophylactic oral penicillin. Compliance studies have not been published for adults in this situation. We used a standard biological assay to detect penicillin in the urine of 58 splenectomized patients.
Why does splenectomy cause infection?
How do you prevent an infection after splenectomy?
Strategies to prevent OPSI include education; vaccination against S. pneumoniae, Haemophilus influenzae type b, Neisseria meningitidis and influenza (annually); and daily antibiotics for at least 2 years postsplenectomy and emergency antibiotics in case of infection.
How do you prevent infection after splenectomy?
Most infections that occur after splenectomy can be avoided through the following measures:
- You should be immunised against the following. Pneumococcus.
- You will probably be advised to take low-dose antibiotics every day for life.
- Keep a course of full-strength broad-spectrum antibiotics handy.