Surgery of the spleen

1. Big picture

Spleen surgery is mainly about balancing bleeding control against preserving immune function.

The spleen is highly vascular, so splenic injury can cause life-threatening hemorrhage. But removing the spleen increases lifelong risk of severe infection, especially from encapsulated bacteria.

The examiner usually wants you to know:

Spleen disease or trauma
      ↓
Is the patient bleeding or unstable?
      ↓
If unstable → emergency laparotomy ± splenectomy
If stable → CT grading ± observation/embolization
      ↓
If elective disease → laparoscopic splenectomy when indicated
      ↓
Always prevent post-splenectomy sepsis

Key oral-exam sentence:

**Splene