Sectional Anatomy

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Sectional Anatomy

• Spleen

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Spleen

• Intraperitoneal organ
• Largest reticuloendothelial system and is
  involved with systemic inflammations, metabolic
  disturbances and hematopoietic disorders
• Found between the left hemidiaphragm and the
  stomach (medial)
• Convex superiorly concave inferiorly
• Pancreas tail abuts the hilium of the spleen

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Spleen
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Spleen (sagittal)
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Spleen

• It is not essential to life however it is a major
  secondary organ in the immune system
• It filters the bloodstream of unwanted elements
  like worn out and damaged RBCs
• It aids in the storage and release of blood like
  in hemorrhage
• It does take an active role in the formation of
  blood in the initial part of fetal development
• Formation of lymphocytes and monocytes

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Spleen

• Size (adult) - 12-14(L) X 7(W) X 3-4(H) cm
• The normal spleen cannot be palpated and must be
  twice its normal size to be felt
• It appears sonographicly to be of uniform medium
  level homogenous texture, just a little less
  echogenic than the liver
• Scanning Technique - 3.5 - 5.0 MHz transducer
• Window - lower left intercoastal spaces or
  subcoastal space, patient can be RLD

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Longitudinal Spleen
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Sagittal Spleen
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Spleen (sagittal)
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Spleen (transverse)
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Spleen (sagittal)

• Left kidney lies inferior and medial to the spleen

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Spleen (transverse)
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Transverse Spleen
transverse
spleen
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Transverse SPLEEN
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Transverse Spleen
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Blood Supply

• SA - is a branch off the celiac trunk, it passes
  anterior posterior to the pancreas body and
  enters the hilium of the spleen
• SV - emerges from the splenic hilium and joins
  the SMV, the IMV drains into the SV and these two
  together join the SMV, all 3 form the PV

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Blood Supply
Transverse spleen
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Spleen and Splenic Vein
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Spleen
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Congenital Disordersof the Spleen

• Asplenia
• Absence of splenic tissue
• Horizontal midline liver
• IVC and aorta are found on the same side of the
  spine
• Associated with congenital heart defects
• More common in females

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Asplenia
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Polysplenia

• More common in males
• Multiple splenuli
• Associated with biliary atresia

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Assessory Spleen

• Occurs in 10 of the population
• Normal variant
• Commonly occurs near the hilium
• Measure between 1 to 3 cm
• Diagnosis is normally suggested by their location
  and texture

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Assessory Spleen

• Same echotexture as the spleen
• Can be confused with a tumor or an enlarged lymph
  node

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Accessory Spleen
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Splenomegaly

• Splenomegaly can be caused by the following
• Congestion
• Secondary to portal HTN and liver cirrhosis (most
  common)
• Infiltrative processes like leukemia lymphoma

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Splenomegaly

• Hypoechoic texture
• Enlarged spleen gt 12 - 14 cm
• When the spleen enlarges it extends inferior and
  medial

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Splenomegaly
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Splenomegaly
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MRI of the Spleen