Most spleen injuries do not need surgery. Children with the Grade 1-3 spleen injuries are usually admitted to a general floor unit and children with a Grade 4-5 spleen injury are usually admitted to the ICU (Intensive Care Unit).
Usually, treatment is strict bed rest for about one to five days, but it may be shorter or longer depending on how badly your child is hurt or if they have other injuries. Sometimes the spleen is seriously injured and won't stop bleeding on its own. If surgery is needed, all efforts are made to save the spleen.
Surgery may be a repair to the spleen (splenorrhaphy), removal of part of the spleen (hemisplenectomy), or removal of the whole spleen (splenectomy). The child will have staples or stitches after surgery. He/she may need to be given some extra blood before or after surgery. The child will not be allowed to eat right away and will have an IV (a small tube placed in the vein) to give fluids.
Your child will be closely monitored in the ICU after surgery for a few days to watch for any bleeding, pain, or infection. Your child will then be transferred to the general floor unit as healing continues.
If your child's spleen was so badly damaged that it needed to be taken out, then the protective workings of the spleen were also removed. There are several ways that these can be partially replaced. To help replace the antibody function or job, your child will need new vaccinations about 10-14 days after surgery or before leaving the hospital.
The vaccines include:
- Pneumovax for pneumococcal infections
- Vaccine for meningococcal infections
- Vaccine for haemophilus influenza type B infections
The pneumovax is repeated every three to five years while the meningococcal vaccine should be given every five years. The haemophilus B vaccine does not need to be given again. Your child may also need to take antibiotics all the time to help the body fight infections. It is important that you tell your doctor or dentist before any procedures that your child's spleen has been removed.