(GI)

Overview

• Spleen → involved in producing protective humoral antibodies, the production and maturation of B and T cells and plasma cells, removal of unwanted particulate matter (eg, bacteria) and also acting as a reservoir for blood cells, especially white cells and platelets
• Causes of Hyposplenism → operative splenectomy, sickle cell anaemia, coeliac disease, chronic lymphoid leukaemia, inflammatory bowel disease, bone marrow transplantation, congenital asplenia
  • Indications for Splenectomy → trauma, spontaneous rupture (eg. in infectious mononucleosis due to minor trauma), hypersplenism, neoplasia (lymphoma or leukaemic infiltration)
• Individuals with an absent or dysfunctional spleen are at increased risk of severe infection, particularly those caused by encapsulated bacteria. The most common organism associated with severe infection is S. pneumoniae (pneumococcus), H. influenzae type b (Hib) and N. meningitidis.

<aside> 💡 NHS ⇒ neisseria meningitidis, haemophilus influenzae, streptococcus pneumoniae

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Making Diagnosis

Clinical Features:

• Sepsis following splenectomy due to infection → pyrexia, hypotension, tachycardia

Investigations:

• Blood Film → howell-jolly bodies, target cells, pappenheimer bodies (siderocytes)
• Imaging → ultrasound, CT or MRI
• Following splenectomy ⇒ thrombocytosis (very high platelet count → may need prophylactic aspirin)

Management Plan