Lesson 5A (Part 2)

Question 1

Wandering spleen

Answer 1

Is a congenital anomaly where the spleen is found in unusual locations due to long lax ligaments

Question 2

What can a wandering spleen be mistaken for?

Answer 2

A mass

Question 3

What can easily happen with wandering spleen?

Answer 3

Torsion

Question 4

What do patients present with with wandering spleen? (2)

Answer 4

1. Acute pain

2. Chronic pain

Question 5

What will confirm the diagnosis of torsion?

Answer 5

Lack of vascularity

Question 6

Asplenia

Answer 6

Is a congenital absence of the spleen

Question 7

What occurs with response to asplenia? (3)

Answer 7

1. Impairment of immune response
2. Sepsis
3. Bacterial meningitis

Question 8

Polysplenia

Answer 8

More than one spleen

Question 9

Retrorenal spleen

Answer 9

An anatomical variant in which the inferior portion of the spleen is located behind the upper left kidney

Question 10

Why are radiologists reluctant to perform splenic intervention procedures?

Answer 10

Because it is highly vascular and they dont want to risk bleeding out

Question 11

What is used to diagnose abnormalities of the spleen?

Answer 11

Fine needle biopsies

Question 12

Splenectomy

Answer 12

Complete removal of the spleen

Question 13

Which is larger, polysplenia or an accessory spleen?

Answer 13

Polysplenule

Question 14

Core biopsy

Answer 14

Getting a sample of tissue

Question 15

Needle biopsy

Answer 15

Getting a sample of cells

Question 16

What may be seen in US when trauma blunt force trauma occurs to the spleen?

Answer 16

Free intra-abdominal fluid

Question 17

Where is a common place where fluid accumulates after trauma?

Answer 17

Morison’s pouch

Question 18

Where is Morison’s pouch located between?

Answer 18

The liver and the right kidney

Question 19

What occurs if the capsule remains intact during trauma? (2)

Answer 19

1. Intraparenchymal

2. Subcapsular hematoma

Question 20

What occurs if the capsule ruptures during trauma? (4)

Answer 20

1. Demonstrate fluid in LUQ
2. Decreased hematocrit
3. May spread through peritoneal cavity
   - morison’s pouch and pelvis
4. A focal or free intraperitoneal hematoma may occur

Question 21

How does a hematoma look like on US?

Answer 21

Initially it is a liquid appearing-anechoic space, but after the blood clots its echogenicity resembles normal spleen

Question 22

What can a hematoma mimic?

Answer 22

Splenomegaly

Question 23

What recuts to easily be able to diagnose hematoma?

Answer 23

Reliquification

Question 24

Splenic infarction

Answer 24

Occlusion of the splenic vascular supply

Question 25

What does splenic infarction lead to? (2)

Answer 25

1. Ischemia

2. Tissue necrosis

Question 26

What are 4 complications with splenic infarction?

Answer 26

1. Hemorrhage
2. Rupture
3. Abscess
4. Pseudocyst

Question 27

How does splenic infarction appear on US? (5)

Answer 27

1. Peripheral, wedge shaped, hypoechoic
2. Echogenicity depends on age of infarct
3. Early stages it is anechoic or hypoechoic
4. Progresses to hyperechoic-fibrosis
5. No flow on colour doppler

Question 28

Splenomegaly (3)

Answer 28

1. Diffuse enlargement
2. Capable of growing to an enormous size
3. Into left iliac fossa

Question 29

What measurements are considered splenomegaly?

Answer 29

> 18cm

Question 30

What are causes of splenomegaly? (5)

Answer 30

1. Hematologic
2. Rheumatologic
3. Infectious
4. Congestive
5. Infiltrative

Question 31

What are complications of splenomegaly? (2)

Answer 31

1. Hypersplenism

2. Spontaneous rupture