Indications for Splenectomy in Hypersplenism
Indication | Examples |
|---|---|
Excessive bleeding | Hypersplenic thrombocytopenia Bleeding esophageal varices requiring concomitant shunt procedure Trauma with ruptured spleen with excessive bleeding |
Hemolytic disorders in which splenomegaly further shortens the survival of intrinsically abnormal red blood cells | Thalassemia |
Mechanical encroachment on other abdominal organs | Calyceal obstruction in left kidney Stomach with early satiety |
Severe pancytopenia associated with massive splenomegaly | Hairy cell leukemia Lipid-storage diseases* |
Splenic congestion due to vascular abnormalities | Splenic vein obstruction due to thrombosis, external compression, or stenosis Bleeding esophageal varices associated with excessive increased splenic venous pressure due to portal hypertension or Budd-Chiari syndrome |
* The spleen may be up to 30 times larger than normal. | |