hematology and oncology
Hypersplenism
Treatment of Hypersplenism
Possibly splenic ablation (splenectomy or radiation therapy) Vaccination and prophylactic antibiotics for splenectomized patients Treatment is directed at the underlying disorder. However, if hypersplenism is the only serious manifestation of the disorder (eg, Gaucher Disease ), splenic ablation by splenectomy or radiation therapy may be indicated. The indications for splenectomy or radiation therapy in hypersplenism are detailed below (see table Because the intact spleen protects against serious infections with encapsulated bacteria, splenectomy should be avoided whenever possible, and patients undergoing splenectomy require prior Overview of Immunization against infections caused by After splenectomy, patients are particularly susceptible to severe Sepsis and Septic Shock with encapsulated microorganisms and are often given daily prophylactic antibiotics such as penicillin, Indication Indication Examples Examples Excessive bleeding Hypersplenic thrombocytopenia Hemolytic syndromes in which splenomegaly further shortens the survival of intrinsically abnormal red blood cells Hereditary Spherocytosis and Hereditary Elliptocytosis None Thalassemias None Mechanical encroachment on other abdominal organs Calyceal obstruction in left kidney Stomach with early satiety Severe pancytopenia associated with massive splenomegaly Hairy cell leukemia Lipid-storage diseases* Overview of Myeloproliferative Neoplasms None Vascular insults involving the spleen Bleeding esophageal varices associated with excessive splenic venous return due to portal hypertension Recurrent infarctions * The spleen may be up to 30 times larger than normal. 