Post-Splenectomy Recovery: Managing Pain and Vaccination Concerns

Post-splenectomy

Hello Dr.
Chen, I am currently two and a half months post-splenectomy due to a car accident.

1.
Recently, I have been experiencing swelling and soreness in my left abdomen and lower back.
Is this condition normal, and what can I do to alleviate it?
2.
Since my surgery was an emergency procedure, my incision is located in the middle of my abdomen (approximately 13 cm in length).
I have been feeling soreness in my abdomen when stretching.
Is this situation normal? Is it appropriate for me to engage in abdominal exercises, or are there other ways to relieve the soreness?
3.
I have already received vaccinations for pneumococcal pneumonia and influenza.
I previously read that some doctors recommend vaccinations for Haemophilus influenzae type B and meningococcal disease.
Should I consider getting these two vaccines as well? Thank you for your response, doctor.

Niming, 20~29 year old female. Ask Date: 2020/12/02

Dr. Chen Jiaming reply Surgery

Trauma from a car accident can cause splenic injury, indicating that the left upper abdomen or lateral chest and abdomen has sustained a significant degree of impact and contusion.
Although it has been two and a half months, if there are residual symptoms from the muscle contusion, some forms of physical therapy may be considered.
For specific methods and intensity, please consult a rehabilitation specialist.
The scar tissue from a midline laparotomy varies from person to person; some may take a few months, while others may take years to gradually soften (becoming less noticeable over time).
Experiencing soreness during exercise may also indicate that deep healing of the wound is not yet complete, so it is not advisable to engage in high-intensity activities.
Improvement in soreness may require "time." It is still recommended to receive vaccinations for Haemophilus influenzae type B and meningococcal disease to reduce the incidence of sepsis (which occurs in 80% of cases within the first two years post-surgery).

Reply Date: 2020/12/02

More Info

Hello! It sounds like you are going through a challenging recovery period after your splenectomy, and I appreciate your detailed questions. Let’s address your concerns one by one.

1. Left Side Abdominal and Lower Back Pain: It is not uncommon to experience some discomfort and swelling in the abdominal area after a splenectomy. The spleen plays a role in filtering blood and immune function, and its removal can lead to changes in how your body responds to infections and inflammation. The pain you are feeling could be due to several factors, including surgical trauma, muscle strain from compensating for the loss of the spleen, or even referred pain from other areas. To manage this discomfort, consider gentle stretching and mobility exercises, but avoid any movements that exacerbate the pain. Applying heat to the area may also help alleviate discomfort. However, if the pain persists or worsens, it’s essential to consult your healthcare provider to rule out any complications such as infection or internal bleeding.

2. Post-Surgical Pain During Stretching: It is normal to feel some pain or discomfort when stretching after abdominal surgery, especially if the incision is still healing. Your body is adjusting to the changes, and the muscles and tissues around the surgical site may still be sensitive. It’s crucial to listen to your body; if certain movements cause significant pain, it may be best to modify or avoid them for now. Gradually reintroducing abdominal exercises can be beneficial, but ensure that you are cleared by your doctor or a physical therapist before starting any rigorous exercise regimen. They can provide tailored advice based on your recovery progress.

3. Vaccination Concerns: After a splenectomy, you are at an increased risk for certain infections, particularly those caused by encapsulated bacteria. The vaccines you mentioned—Haemophilus influenzae type b (Hib) and meningococcal vaccines—are indeed recommended for individuals who have had their spleen removed. These vaccines help protect against infections that your body may struggle to fight off without the spleen. It’s advisable to discuss with your healthcare provider about your vaccination schedule and ensure that you receive all necessary vaccines to protect your health. They may also recommend additional vaccinations based on your medical history and lifestyle.

In summary, while some discomfort is expected after a splenectomy, it’s essential to monitor your symptoms closely. If you experience severe pain, swelling, or any signs of infection (such as fever or increased redness around the incision), seek medical attention promptly. Additionally, maintaining open communication with your healthcare provider regarding your recovery and vaccination needs is crucial for your long-term health.
Take care, and I wish you a smooth recovery!

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