Most spleen injuries do not need surgery. Children with the grade 1-4 spleen injuries are usually admitted to the general care unit and children with a grade 5 spleen injury may be admitted to the intensive care unit (ICU). Fortunately, most spleen injuries are treated without surgery. Depending on the grade of the injury, treatment can include strict bedrest, nothing to eat or drink for a short period of time, pain control, lab work and IV fluid hydration. Blood transfusions can sometimes be necessary.
Sometimes the spleen is so badly injured and won't stop bleeding on its own. In these rare cases surgery is needed to remove the spleen.
If your child has surgery, he / she will not be allowed to eat after surgery for some time. However, he/she will be given an IV (a small tube in their vein) for fluid hydration. He/she may also have a nasogastric tube (a tube through the nose into the stomach) after surgery to keep their stomach empty.
We will observe your child closely in the ICU after surgery for a few days to watch for any bleeding, pain or infection. Your child will then transfer to the general floor unit as healing continues.
If your child's spleen was so badly injured that it was removed, the protective workings of the spleen were also removed. To help replace the antibody function, your child will need new vaccinations about 10-14 days after surgery or before leaving the hospital. Your trauma surgery provider and your child’s primary care doctor will decide which vaccines will be necessary for your child.
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.