Splenic sequestration (SPLIN-ik see-kweh-STRAY-shen) happens when sickle-shaped cells block blood flow in the spleen, making it get large and painful. When these cells get trapped in the spleen, there are suddenly too few oxygen-carrying blood cells circulating in the blood, leading to low hemoglobin. Your child was treated for splenic sequestration and is doing better. Follow these instructions to care for your child at home.

• While the spleen is enlarged, help protect it from injury. Until the health care provider says it's OK, your child should avoid riding a bike, climbing, rough play, contact sports, heavy lifting, and strenuous activity that could injure the spleen.
• Let your child rest until they feel well enough to do normal activities. It's OK to go to school when your child has enough energy, and the belly pain is mild or gone. 
• If the care team asked you to check your child's spleen size, follow their instructions on how to do it and how often.
• Schedule a follow-up visit with your child's hematologist so they can check the spleen and repeat the blood work to check the hemoglobin level.
• Keep giving your child the daily medicines that your health care provider prescribed, unless the hospital health care team told you to stop them.
• Give any new medicines prescribed during the hospital stay.
• Be sure your child drinks plenty of fluids to stay hydrated.

Your child has:

• a fever of 101°F (38.3°C) or higher and/or chills
• increasing left side pain
• severe belly pain or swelling
• a spleen that feels bigger or more firm (or you think it might be), or is tender to touch
• fatigue (extreme tiredness or less playful)
• dizziness
• a fast heartbeat
• pale skin 
• a severe headache

The hematologist knows your child's health better than any other health care provider. So it's always best to call them when there's a problem.

Your child:

• has trouble seeing
• has trouble talking
• has weakness in part of the body
• has a seizure
• is hard to wake up
• struggles to breathe

When you call 911, tell emergency responders that your child has sickle cell disease.

What does the spleen do? The spleen:

• filters germs out of the blood
• filters old, damaged blood cells out of the blood
• makes the white blood cells that help the body fight germs

Why does splenic sequestration happen? Sickle cells are pointy, stiff, and sticky and can get stuck in the spleen's blood vessels. 

How is splenic sequestration treated in a hospital? Kids with splenic sequestration get fluids through an IV, and sometimes blood transfusions. IV fluids help to "flush" the trapped cells out of the spleen. In a red blood cell transfusion, the new transfused blood cells can carry oxygen to the spleen and the rest of the body. After the spleen gets more oxygen, it releases the trapped blood cells and gets smaller, and the child starts to feel better.

Can my child get splenic sequestration again? Yes. Kids who have had splenic sequestration are more likely to have it again. Make sure you and your child know the signs so you can get treatment quickly if it happens again. Watch for:

• increasing left side pain
• severe belly pain or swelling
• fatigue (extreme tiredness)
• dizziness
• a fast heartbeat
• pale skin
• a headache