Chennai, May 29: Doctors at SRM Prime Hospital successfully removed a massive 2.8 kg spleen from a 23-year-old woman from Bihar through a complex laparoscopic-assisted splenectomy, a minimally invasive surgical procedure.
The patient also had non-cirrhotic portal fibrosis, a condition in which the blood vessels supplying the liver become scarred and narrowed without actual liver cirrhosis, along with hypersplenism, a disorder in which the enlarged spleen becomes overactive and destroys blood cells. Doctors said the rare and medically challenging condition had caused severe abnormalities in her blood parameters and overall health.
The young homemaker had been experiencing persistent fatigue, generalised weakness, and early exhaustion in performing daily activities. Initial medical evaluation in Bihar revealed liver- and spleen-related abnormalities, following which she was referred to SRM Prime Hospital for advanced treatment.
Detailed investigations revealed severe abnormalities in her blood counts, including critically low hemoglobin (5.7 g/dL), white blood cells (1600/mm³), and platelet levels (30,000/mm³), placing her at high risk of bleeding and infection. An advanced CT scan revealed a massive spleen measuring approximately 21.2 × 16.4 × 14.2 cm and weighing nearly 2.8 kilograms.
Pre-operatively, the patient was evaluated by Dr. Arulprakash S, Clinical Lead & Senior Consultant – Medical Gastroenterology & Hepatology and Dr. CH Dheeraj, Consultant – Medical Oncology to rule out any medically treatable conditions like Myeloproliferative neoplasms. Subsequently, the patient underwent a successful laparoscopic-assisted splenectomy performed by Dr. R. V. Sugi Subramaniam, Senior Consultant – Surgical Gastroenterology, HPB Surgery & Laparoscopic Surgery, along with the anesthesia team.
In his comments, Dr. Sugi Subramaniam said,
“Abnormal enlargement of the spleen associated with non-cirrhotic portal fibrosis is rare and surgically demanding. In this patient, the enlarged spleen, combined with extremely low blood counts and portal hypertension, had significantly increased the surgical risk. The unusually large spleen made the procedure more complex because of distorted anatomy, fragile surrounding blood vessels, and the elevated risk of bleeding during surgery. Despite these challenges, the surgery was performed successfully through a minimally invasive approach. The patient recovered well after the procedure and showed significant clinical improvement and was discharged on Day 5.”