Due to associated diseases, the function of the spleen may be modified, in turn causing certain
complications, such as anaemia, altered coagulation, malnutrition and organ failure. Preoperative
management of patients must take these two possibilities into account. In non-traumatic splenectomies, blood
samples are necessary to screen for thrombophilia: antithrombin III deficiency, protein C deficiency, protein
S deficiency and dysplasminogenemia. Complete blood count, AST, ALT, serum amylase, C-reactive
protein, thrombin-AT-III complex and D-dimer also become necessary perioperatively. The preoperative
management of anaemia must evaluate the risk and benefits of blood transfusion. Malnutrition increases the
risk of postoperative complications. Antibiotics are recommended for patients who are immunosuppressed
and in trauma. In the classical form of spleen surgery, pain is a frequent symptom, with variable intensity,
mostly due to the pressure applied to the ribs. If the pain is not well managed by specific pills, it is better to
make an anaesthetic block of the thoracic nerves. Thrombosis extending into the portal vein is rare; with an
overall risk of 3.3%. Infection is the most common postoperative complication. Fever commonly appears
between the fourth and seventh day after surgery. The risk of thromboembolic events and pulmonary arterial
hypertension varies greatly, depending on the underlying condition for which the splenectomy is performed
and its association with intravascular haemolysis. The most serious septic complication after splenectomy is
the (OPSI), which brings about a prohibitory mortality rate of 50% to 90%. Prevention of postsplenectomy
sepsis has occurred through the use of greater efforts to avoid splenectomies.
