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What causes pain and swelling in upper left abdominal area after spleen removal?

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Posted on Fri, 11 Jul 2014
Question: My son had his spleen removed ten years ago and is now experiencing pain and swelling in the upper left abdominal area. He is a long haul truck driver and is in the middle of a route. He has gone into two doctors. They say his white count is elevated but won't give him antibiotics,and also say there is an abnormality suggesting that part of the spleen is still there. There is no fever. His medical records are in XXXXXXX and he is currently in flagstaff. He doesn't know what to do and I don't know what to advise. Any suggestions? Thank you.
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Answered by Dr. Karen Steinberg (3 hours later)
Brief Answer:
Need more information

Detailed Answer:
Hello, thank you for using Healthcare Magic. It is difficult to suggest anything new without knowing exactly what the 2 doctors did and what they thought it was. It sounds like they might have done a scan of some sort if they think part of the spleen is still there. This is where I would start, with a physical exam and radiologic studies of the area of swelling. Antibiotics are not given unless an infection is present. The elevated white count (just how high is it?) could indicate other processes. This could be something as simple as gas collecting in the splenic flexure of the colon, which would be in the upper left abdomen, or perhaps the beginning of something more serious, such as a bowel obstruction. (Sometimes scarring from a previous surgery can cause this.) What other symptoms does he have? What other bloodwork was done? Why was his spleen removed in the first place?

If he hasn't been to an emergency room, I would suggest that (although I assume these 2 doctor visits might have been emergency visits?) If his medical records are in XXXXXXX the next doctor he sees could get them if he signs a release. He should mention that. I don't know what kind of scan he already had, but perhaps he needs another study that shows more. If it is a primary colon problem, some routine scans may not be helpful at all. He might need something specific to look at the colon. Certainly if symptoms are progressing, he should go to emergency.

Please let me know if there is more information or you have more questions.
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Dr. Karen Steinberg

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What causes pain and swelling in upper left abdominal area after spleen removal?

Brief Answer: Need more information Detailed Answer: Hello, thank you for using Healthcare Magic. It is difficult to suggest anything new without knowing exactly what the 2 doctors did and what they thought it was. It sounds like they might have done a scan of some sort if they think part of the spleen is still there. This is where I would start, with a physical exam and radiologic studies of the area of swelling. Antibiotics are not given unless an infection is present. The elevated white count (just how high is it?) could indicate other processes. This could be something as simple as gas collecting in the splenic flexure of the colon, which would be in the upper left abdomen, or perhaps the beginning of something more serious, such as a bowel obstruction. (Sometimes scarring from a previous surgery can cause this.) What other symptoms does he have? What other bloodwork was done? Why was his spleen removed in the first place? If he hasn't been to an emergency room, I would suggest that (although I assume these 2 doctor visits might have been emergency visits?) If his medical records are in XXXXXXX the next doctor he sees could get them if he signs a release. He should mention that. I don't know what kind of scan he already had, but perhaps he needs another study that shows more. If it is a primary colon problem, some routine scans may not be helpful at all. He might need something specific to look at the colon. Certainly if symptoms are progressing, he should go to emergency. Please let me know if there is more information or you have more questions.