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Miscellaneous - Spleen

Dr Jules Eden, dive medicine specialist and founder of e-med, answers divers' questions - as published in Sport Diver magazine:
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Q - Hello. My boyfriend recently had his spleen removed. He is taking antibiotics for life, but still wants a career in diving (commercial). Is there any medical reason he would not be able to pursue a career in diving? I have read some information and I realise he will be slightly more susceptible to infection without a spleen, but with the vaccinations/antibiotics and the locations he dives in, is it still a possibility?

A - I always like a little historical background to place things in context. In the 17th century the spleen was thought to be the repository of “ill humour and melancholy”, and was particularly applied to women in bad moods who were said to be “afflicted by the vapours of spleen”. Venting it was the term given to an angry (so-called “splenic”) person letting rip. Such as I do when watching the preposterous antics of many a vacuous Big Brother contestant.

The spleen is in fact a vastly underrated pear-sized organ which lies just under the rib cage on the left hand side of the body. It acts as a reservoir of blood and is the site of destruction of worn out red blood cells. Interestingly horse spleens contain litres of blood which are squeezed out when the horse pelts off. The spleens of diving mammals are even more well adapted. The spleen of the Arctic Weddell seal contains so much extra oxygenated blood that it often is referred to as a SCUBA tank – when it dives the blood ejected leaves the spleen up to 85% smaller! It’s also full of special cells called macrophages that filter out bacteria and other bloodborne nasties. Hence its absence does lead to a predisposition to infection (generally estimated at around 12 times the rate of individuals with a spleen), and the need for lifelong antibiotics. And this is the issue with a commercial diving career – your boyfriend may be working in remote locations with poor (if any) access to medical facilities. Any minor ailment (a sniffle or a cut for example) may turn into a major infection requiring heavy duty antibiotics, so access to appropriate treatment is a must. Apart from this risk and its practical implications, there’s no reason your boyfriend can’t pursue his diving ambitions.

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