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Definition

You had surgery to remove your spleen. This operation is called splenectomy. Now that you're going home, follow your surgeon's instructions on how to care for yourself while you heal.

When You're in the Hospital

The type of surgery you had is called open surgery. The surgeon made a cut (incision) in the middle of your belly or on the left side of your belly just below the ribs. If you are being treated for cancer, the surgeon probably also removed the lymph nodes in your belly.

What to Expect at Home

Recovering from surgery takes 4 to 8 weeks. You may have some of these symptoms as you recover:

• Pain around the incision for a few weeks. This pain should lessen over time.
• Sore throat from the breathing tube that helped you breathe during surgery. Sucking on ice chips or gargling may help soothe your throat.
• Nausea and maybe throwing up. Your surgeon can prescribe nausea medicine if you need it.
• Bruising or skin redness around your wound. This will go away on its own.
• Trouble taking deep breaths.

If your spleen was removed for a blood disorder or lymphoma, you may need more treatments. This depends on your medical disorder.

Activity

Make sure your home is safe as you are recovering. For example, remove throw rugs to prevent tripping and falling. Be sure that you can use your shower or bath safely. Have someone stay with you for a few days until you are sure you can take care of yourself.

You should be able to do most of your regular activities in 4 to 8 weeks. Before that:

• Do not lift anything heavy until your surgeon says it is OK.
• Avoid all strenuous activity. This includes heavy exercising, weightlifting, and other activities that make you breathe hard, strain, or have pain or discomfort.
• Short walks and using stairs are OK.
• Light housework is OK.
• Do not push yourself too hard. Gradually increase how much you are active.

Managing Pain

Your surgeon will prescribe pain medicines for you to use at home. If you are taking pain pills 3 or 4 times a day, try taking them at the same times each day for 3 to 4 days. They may be more effective this way. Ask your surgeon about taking acetaminophen (Tylenol) or ibuprofen for pain instead of narcotic pain medicine.

Try getting up and moving around if you are having pain in your belly. This may ease your pain.

Press a pillow over your incision when you cough or sneeze to ease discomfort and protect your incision.

Wound Care

Care for your incision as instructed. If the incision was covered with skin glue, you may shower with soap the day after surgery. Pat the area dry. If you have a dressing, change it daily and shower when your surgeon says it is OK.

If strips of tape were used to close your incision:

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

Do not soak in a bathtub or hot tub or go swimming until your surgeon tells you 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 infections.

After your spleen is removed, you will be more likely to get infections:

• For the first week after surgery, check your temperature every day.
• Tell the surgeon right away if you have a fever, sore throat, headache, belly pain, or diarrhea, or an injury that breaks your skin.

Keeping up to date on your immunizations will be very important. Ask your doctor if you should have these vaccines:

• Pneumococcal
• Meningococcal
• Haemophilus influenzae
• Flu shot (every year)

Things you can do to help prevent infections:

• Avoid crowds for the first 2 weeks after you go home.
• Wash your hands often with soap and water. Ask family members to do the same.
• Get treated for any bites, human or animal, right away.
• Protect your skin when you are camping or hiking or doing other outdoor activities. Wear long sleeves and pants.
• Tell your provider if you plan to travel out of the country.
• Tell all of your providers (dentist, doctors, nurses, or nurse practitioners) that you do not have a spleen.
• Buy and wear a bracelet that indicates you do not have a spleen.

When to Call the Doctor

Contact your provider if you have any of the following:

• Temperature of 101°F (38.3°C), or higher
• Incisions are bleeding, red or warm to the touch, or have a thick, yellow, green, or pus-like drainage
• Your pain medicines are not working
• It is hard to breathe
• Cough that does not go away
• Cannot drink or eat
• Develop a skin rash and feel ill

References

Arber DA. Spleen. In: Goldblum JR, Lamps LW, McKenney JK, Myers JL, eds. Rosai and Ackerman's Surgical Pathology. 11th ed. Philadelphia, PA: Elsevier; 2018:chap 38.

Nazzar AK, Hawn M. The spleen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 57.

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