Splenectomy is performed for trauma, hematologic disease, or tumors. Early post-operative and long-term symptoms stem from the loss of immune, blood-filtering, and platelet-pooling functions.
Early post-op (days–weeks)
- Left upper-quadrant pain
Incisional or referred shoulder-tip ache from diaphragmatic irritation; worst on deep inspiration or coughing. - Fatigue and weakness
General post-surgical lethargy plus mild anemia while hemoglobin equilibrates. - Swelling & bruising
Soft-tissue edema and flank ecchymosis resolve gradually. - Nausea, hiccups, ileus
Temporary gastric stasis or diaphragmatic spasm is common.
Long-term (months–life)
- Increased infection risk / OPSI
Sudden high fever (>38 °C), chills, myalgia, headache, vomiting, abdominal pain, confusion, rapid progression to septic shock within 12–24 h; highest risk in first 2 years . - Thrombocytosis
Platelets often rise to >400–600 ×10⁹/L; may cause headache, fingertip tingling, or (rarely) venous thrombosis. - Leukocytosis & Howell-Jolly bodies
Persistent neutrophilia and red-cell inclusions on blood film are expected markers of asplenia. - Easy bruising / petechiae (if associated platelet dysfunction)
Minor trauma produces bruises; spontaneous petechiae can occur when counts exceed 1000 ×10⁹/L. - Digestive discomfort
Some patients report transient bloating, early satiety, or left-sided fullness as organs shift into the splenic bed.
Seek immediate care for any fever ≥38 °C, rigors, or rapid clinical deterioration—assume OPSI until proven otherwise.
| Symptom | Usual Time-frame | Red-flag Action |
|---|---|---|
| LUQ pain | Days–weeks | Worsening → bleed/abscess |
| Fever | Any time | ≥38 °C → blood cultures + empiric antibiotics |
| Fatigue | 1–4 weeks | Persistent anemia check |
| Platelets | 1–8 weeks | >1000 ×10⁹/L → consider aspirin |
| Bruising | Ongoing | Spontaneous petechiae → hematology review |
| OPSI prodrome | Hours | High fever, chills, confusion → ER |