A diagnostic aspirate of the spleen can be done safely in most patients but a few patients may have a complication following the procedure. A severe complication may necessitate splenectomy.
Risk factors for complications associated with a splenic aspirate:
(1) moderate to severe coagulopathy (prolonged PT or PTT, thrombocytopenia, antiplatelet drugs, etc)
(2) multiple needle passes
(3) inexperienced operator
(4) larger diameter to the needle (core biopsy rather than needle aspirate)
(5) failure to fast prior to the procedure
(6) failure to rest for an adequate period (2 hours or more) after the procedure
(7) friable splenic tissue (rapidly distended with increased pressure)
A patient undergoing a splenic aspirate should have a follow-up evaluation (clinical interview, complete blood count, ultrasonography) the day after the procedure to detect bleeding or other complications. An evaluation can be done sooner if the patient becomes symptomatic.
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Specialty: Hematology Oncology, Clinical Laboratory