Which of the following is a complication of splenectomy?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2018

Medical & Surgical Nursing

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2018

Explanation

Pancreatitis is a potential complication of splenectomy due to the anatomical proximity of the pancreas to the spleen.
The tail of the pancreas extends to the splenic hilum, the area where blood vessels are tied off during the procedure.
Surgical manipulation or trauma to the pancreatic tail during the splenectomy can lead to inflammation, causing pancreatitis.
Monitoring for elevated serum amylase and lipase is a key nursing action to detect this complication early.

Option A: Cholecystitis is inflammation of the gallbladder. The gallbladder is located in the right upper quadrant of the abdomen, anatomically distant from the spleen, which is in the left upper quadrant. It is not typically at risk of injury during a splenectomy.
Option C: Appendicitis is inflammation of the appendix. The appendix is located in the right lower quadrant of the abdomen and is not in the surgical field of a splenectomy.
Option D: Gastritis is inflammation of the stomach lining. While the stomach is near the spleen, gastritis is generally caused by factors like H. pylori infection, NSAID use, or alcohol, not direct surgical trauma from a splenectomy.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Postoperative complications of splenectomy as background academic context rather than a clinical decision trigger.
Recognizing potential complications is a core nursing responsibility. Early detection of pancreatitis through vigilant monitoring of pain and lab values (amylase/lipase) can prevent severe outcomes.
The most life-threatening long-term complication of splenectomy is Overwhelming Post-Splenectomy Infection (OPSI). Nurses play a critical role in patient education regarding lifelong infection risk, the need for vaccinations, and seeking immediate care for fever.
What if? If the patient had a laparoscopic splenectomy, the nurse should also be vigilant for signs of portal vein thrombosis, another known complication, which can present as abdominal pain, ascites, or splenomegaly (if residual splenic tissue exists).

How to Approach the Question

First, identify the core concept of the question: complications of a specific surgical procedure (splenectomy).
Recall the anatomy of the upper abdomen. Visualize the location of the spleen in the left upper quadrant.
Consider which organs are in close proximity to the spleen. The stomach, the diaphragm, the left kidney, and the tail of the pancreas are all nearby.
Evaluate each option based on this anatomical knowledge. Cholecystitis (gallbladder) and appendicitis (appendix) involve organs in the right quadrants, making them unlikely direct complications.
Between gastritis (stomach) and pancreatitis (pancreas), consider the specific surgical actions. A splenectomy involves ligating the splenic vessels at the hilum, which is immediately adjacent to the pancreatic tail.
Conclude that the pancreas is the most likely organ among the choices to be inadvertently injured during the procedure, leading to pancreatitis.

Concept Tested & Keywords

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