What are spleen problems?

• The spleen is an organ in the upper-left section of the abdomen near the stomach.
• The spleen is responsible for filtering out old and damaged blood cells. It is also a part of the immune system, which protects the body against infection.
• The spleen filters out certain types of bacteria. If it is not working well, the body can get an overwhelming infection very quickly and additional precautions should be taken if the spleen is missing or not working.
• It is an important organ but is not critical to survival.

How common are they?

Because the spleen can be affected differently by different diseases, it is difficult to say how many children have spleen problems.

What are some common characteristics of children who have spleen problems or of spleen problems as children present with them?

• Other conditions mentioned in this book may affect the spleen, such as sickle cell disease and other blood diseases, as well as cancer.
• The spleen can also be enlarged temporarily in children with infectious mononucleosis or HIV infection.
• Sometimes, the spleen is injured during trauma and must be removed surgically.
• Some children are born with abnormal spleens.
• The spleen can be a problem if it is enlarged, does not work properly, or is missing.

What adaptations may be needed?

Medications

• Some children take penicillin to prevent overwhelming bacterial infections. This medication should be included in the Care Plan.
• Vaccines, such as pneumococcal and meningococcal conjugate vaccines, help prevent infections that can be overwhelming in a child without a functioning spleen.
• All children and staff should be fully immunized, including with influenza vaccine. This step protects everyone against vaccine-preventable illnesses.

Physical Environment and Other Considerations

Children with enlarged spleens may be at risk for rupturing (breaking open) the spleen, which is a life-threatening emergency. Therefore, it is important to avoid hitting the abdomen of a child in rough play or sports activities if the child’s spleen is enlarged. Sometimes, the cause of an enlarged spleen is temporary, such as infectious mononucleosis, and sometimes it is chronic, such as a blood disease.

What should be considered an emergency?

• Fever can be a more serious symptom and should be evaluated immediately by a health care professional capable of performing blood studies and administering antibiotics to a child with an absent spleen or a nonfunctioning spleen.
• Call emergency medical services (911) for
  • Serious pain in the upper-left section of the abdomen
  • A child who appears pale or weak
  • Fever if the parents/guardians cannot take their child for immediate evaluation
  • Serious trauma to the abdomen in a child known to have an enlarged spleen
  • Enlarging spleen (belly swelling)
• Call parents/guardians for
  • Fever if the Care Plan specifies that the parents/guardians will take their child for evaluation and the parents/guardians are able to do so
  • Decreased energy
  • Minor abdominal pain or discomfort
  • Minor abdominal trauma

What types of training or policies are advised?

Recognizing signs and symptoms of possible emergency

Source: Managing Chronic Health Needs in Child Care and Schools: A Quick Reference Guide.

Products are mentioned for informational purposes only. Inclusion in this publication does not imply endorsement by the American Academy of Pediatrics.

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

© 2019 American Academy of Pediatrics. All rights reserved.