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 decrease:

• 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) may be soothing for them.
• Bruising, skin redness, or pain around the cut, or cuts
• Problems taking deep breaths

If your spleen was removed for a blood disorder or lymphoma, you may need additional treatment, depending on your medical disorder.

Activity

If your child is an infant, try not to let them cry for too long for the first 3 to 4 weeks after surgery. Staying calm yourself will help your baby stay calm. When you lift your baby, support both their 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 doctor or nurse will tell you when it is okay for your child to return to school or daycare. This may be as soon as 2 - 3 weeks after surgery.

For the first 2 -3 weeks after surgery, your child should not do any activity where there is a chance of falling. Your child also should not go bicycling, skateboarding, roller skating, play any contact sports, or lift anything heavier than 3 pounds.

Climbing stairs is okay. Swimming is okay after the tape strips (Steri-Strips) have fallen off your child’s surgical wounds, and the doctor says it is okay.

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

Make sure your home is safe. See also: Bathroom safety - children

Wound Care

Your doctor will tell you when to stop keeping your child's wounds covered. Keep the wound area clean by washing it with mild soap and water. See also: Surgical wound care

You may remove the wound dressings (bandages) and give your child a shower. If Steri-Strips 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 Steri-Strips 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 doctor says it is okay.

Preventing Infections

Most people live a normal active life without a spleen, but there is always a risk of an infection.

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

• Risk for 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 doctor 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 doctor if your child should have these vaccinations:

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

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

These things will help prevent infections in your child:

• Get your child treated for any bites, especially dog bites, right away.
• Let your child’s doctor 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 their immunizations are up to date.
• Tell all of your child’s health care providers (dentist, doctors, nurses, or nurse practitioners) that your child does not have a spleen.
• Ask your child’s doctor or nurse about a special bracelet for your child to wear that says your child does not have a spleen.

Other Self-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 doctor first if this is right for your baby. Your child’s doctor or nurse may tell you how to add extra calories to formula.

Give toddlers and older children a regular, healthy diet. The doctor or nurse will tell you about any changes you should make.

When to Call the Doctor

Call your doctor or nurse if:

• Your child’s temperature is above 101 °F.
• 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 appears lethargic, is not eating, and looks ill.

Alternate Names

Splenectomy - child - discharge; Spleen removal - child - discharge

References

Cadili A, de Gara C. Complications of splenectomy. American Journal of Medicine. May 2008;121(5).

Beauchamp RD, Holzman MD, Fabian TC, Weinberg JA. The spleen. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 56.

Price VE, Blanchette VS, Ford-Jones EL. The prevention and management of infections in children with asplenia or hyposplenia. Infectious Disease Clinics of North America. September 2007;21(3).

Update Date: 2/9/2011

Updated by: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.