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Definition

Your child had surgery to remove the spleen. Now that your child is going home, follow the surgeon's instructions on how to care for your child at home. Use the information below as a reminder.

When Your Child Was in the Hospital

Your child's spleen was removed after your child was given general anesthesia (asleep and pain-free).

• If your child had open surgery, the surgeon made an incision (cut) in your child's belly.
• If your child had laparoscopic surgery, the surgeon made 3 to 4 small cuts in your child's belly.

What to Expect at Home

Most children recover quickly after spleen removal. Recovery from laparoscopic surgery is usually faster than recovery from open surgery.

Your child may have some of these symptoms. All of them should slowly go away:

• Pain around the incisions for a few days.
• Sore throat from the breathing tube. Sucking on ice chips or gargling (if your child is old enough to do these things) can help soothe the throat.
• Bruising, skin redness, or pain around the cut, or cuts.
• Problems taking deep breaths.

If your child's spleen was removed for a blood disorder or lymphoma, your child may need more treatment depending on the disorder.

Activity

When you lift your baby, support both the baby's head and bottom for the first 4 to 6 weeks after surgery.

Toddlers and older children will often stop any activity if they get tired. Do not press them to do more if they seem tired.

Your health care provider will tell you when it is OK for your child to return to school or daycare. This may be as soon as 1 to 2 weeks after surgery.

Your child's activity restrictions will depend on:

• The type of surgery (open or laparoscopic)
• Your child's age
• The reason for the operation

Ask your provider about specific activity instructions and limitations.

In general, walking and climbing stairs is OK.

You can give your child acetaminophen (Tylenol) for pain. The doctor may also prescribe other pain medicines to use at home if your child needs them.

Wound Care

Your surgeon will tell you when to remove your child's dressings. Care for the incisions as instructed. Keep the incision area clean and dry. Only wash it if instructed by your doctor.

You may remove the incision dressings (bandages) to give your child a shower. If strips of tape or surgical glue were used to close the incision:

• Cover the incision with plastic wrap before showering for the first week.
• Do not try to wash off the tape or glue. They will fall off in about a week.

Your child should not soak in a bathtub or hot tub or go swimming until your surgeon says it is OK.

Preventing Infections

Most people live a normal active life without a spleen, but there is always a risk of getting an infection. This is because the spleen is part of the body's immune system, helping fight certain infections.

Your child will be more likely to get infections without a spleen:

• Risk of infection is highest in the first 2 years after surgery, or until your child is 5 or 6 years old.
• Always tell your child's provider if your child has a fever, sore throat, headache, belly pain, or diarrhea, or an injury that breaks the skin. Most of the time, problems like these will not be serious. But, sometimes they can lead to major infections.

For the first week after surgery, check your child's temperature every day.

Ask your child's provider if your child should have (or already had) these vaccines:

• Pneumonia
• Meningococcal
• Haemophilus
• Flu shot (every year)

Your child may need to take antibiotics every day for a while. Tell your child's provider if the medicine is causing your child any problems. Do not stop giving antibiotics before checking with your child's provider.

These things will help prevent infections in your child:

• Teach your child to wash their hands often with soap and water. Family members should do the same.
• Get your child treated for any bites, especially dog bites, right away.
• Let your child's provider know if your child will be traveling out of the country. Your child may need to carry extra antibiotics, take precautions against malaria, and make sure immunizations are up to date.
• Tell all of your child's providers (dentist, doctors, nurses, or nurse practitioners and others) that your child does not have a spleen.
• Ask your child's provider about a special bracelet for your child to wear that says your child does not have a spleen.

Other Care

After surgery, most babies and infants (younger than 12 to 15 months) can take as much formula or breast milk as they want. Ask your child's provider first if this is right for your baby. Your child's provider may tell you how to add extra calories to formula.

Give toddlers and older children regular, healthy foods. The provider will tell you about any changes you should make.

When to Call the Doctor

Contact the provider if:

• Your child's temperature is 101°F (38.3°C) or higher.
• The surgical wounds are bleeding, are red or warm to the touch, or have a thick, yellow, green, or milky drainage.
• Your child has pain that is not helped by pain medicines.
• It is hard for your child to breathe.
• Your child has a cough that does not go away.
• Your child cannot drink or eat.
• Your child is not as energetic as usual, is not eating, and looks ill.

References

Brandow AM, Camitta BM. Hyposplenism, splenic trauma, and splenectomy. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 514.

Rescorla FJ, Vandewalle RJ. Splenic conditions. In: Holcomb GW, Murphy JP, St. Peter SD, eds. Holcomb and Ashcraft's Pediatric Surgery. 7th ed. Philadelphia, PA: Elsevier; 2020:chap 47.

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