Discharge Instructions for Laparoscopic Splenectomy (Pediatric)
Your child had a splenectomy. This is surgery to remove the spleen from the upper left belly area (abdomen). The spleen filters blood and helps the body fight infection. For this procedure, your child’s surgeon made 3 or 4 small cuts (incisions) in your child’s belly. Tiny surgical tools were inserted through these incisions. This method lets your child recover from surgery more quickly and with less discomfort. Here's what you need to know about caring for your child at home.
Check your child’s incisions daily for redness, swelling, or separation of the skin.
Follow the surgeon's instructions on when your child can take a bath or shower.
Make sure you or your child washes the incision sites gently. Use mild soap and warm water, and pat them dry.
Ask the surgeon when it will be safe for your child to lift things or get back to normal activities.
Remember, your child will be a little unsteady on his or her feet for a few days after getting home from the hospital.
Don’t allow your child to lift anything heavier than 3 pounds. This is to avoid straining the incisions.
Give your child a break from chores. Your child shouldn’t push a vacuum or mow the lawn until the healthcare provider says it’s OK to do so.
Give your child pain relievers as directed. Avoid aspirin and ibuprofen.
Taking precautions about infections
Check your child’s temperature every day for 1 week after the surgery.
Make sure your child takes all the antibiotics prescribed after surgery—even if he or she feels better. Your child needs the antibiotics to keep from getting an infection.
Get medical attention for your child even for mild illnesses. This includes sinus problems or colds. Remember, your child is more likely to get an infection without a spleen.
Make sure your child is up to date on all vaccines. Talk with your child’s healthcare provider about any vaccines your child may need.
Be sure to tell all your child's healthcare providers that your child does not have a spleen.
Think about getting a medical ID (identification) bracelet for your child. It should say that your child does not have a spleen.
Follow up with your healthcare provider, or as advised.
When to call your child's healthcare provider
Call your child's healthcare provider right away if your child has any of the following:
Fever (see Fever and children, below)
Feeling dizzy or lightheaded
Any abnormal bleeding
Pain in or around the incision site
Warmth or redness at or around the incision site
Incision site that opens up or pulls apart
Belly pain that gets worse
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Child age 3 to 36 months:
Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider
Child of any age:
Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.
August 15, 2018
Fever in infants and children: Pathophysiology and management. UpToDate.
Adler, Liora C., MD,Fraser, Marianne, MSN, RN,Turley, Ray, BSN, MSN