Laparoscopic Splenectomy Case Study

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Laparoscopic splenectomy is preferred over open splenectomy as it is safe and effective.29It has an exclusion criterion for the following cases; trauma, portal hypertension and high anesthesia risk due to cardiorespiratory and allied conditions.29 A patient with an indication for splenectomy has to undergo a few preoperative examinations as well as vaccinations. A spiral CT scan is used to check the size and volume of the spleen, as well as accessory splenic tissue preoperatively.30 Vaccination against pneumococcal, meningococcal and Haemophilus influenza type B infection is of standard recommendation two-three weeks prior splenectomy.30
Under general anesthesia, the patient is placed laterally on the right decubitus position with the left
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These patients are at a greater risk of infection from encapsulated bacteria – i.e. Streptococcus pneumonia, Haemophilus influenza serotype b (Hib) and Neisseria meningitidis. They are, thus, predisposed to infectious conditions elicited by these bacteria – e.g.: bacterial meningitis, bacterial pneumonia, and clinically significant respiratory and GIT infections.36-37 However, other types of infections may be due to Gram negative bacteria such as, Capnocytophaga canimorsus and the malaria parasite P. falciparum.36The incidence of post-splenectomy infections is 0.5% with 50% mortality; with children enduring severe infections. Literature reveals that the incidence of infections is higher in the 2 years following the surgery, especially from pneumococcal infections. The management of splenectomized patients is critical in reducing the risk of post-infections. This involves: providing adequate education to the patient with regard to the immunological function of the spleen and the risk of infection by encapsulated bacteria, vaccination and antibiotic prophylaxis as the cornerstone of preventative treatment against these…show more content…
deep vein thrombosis, pulmonary embolism, coronary artery disease, myocardial infarction and ischemic stroke). 36-37There is no definitive treatment for PVT however prophylaxis using a combination of low molecular weight heparin and/or warfarin and/or thrombolytic agents is the cornerstone of managing the
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