Lesson 5A (Part 2) Flashcards
Wandering spleen
Is a congenital anomaly where the spleen is found in unusual locations due to long lax ligaments
What can a wandering spleen be mistaken for?
A mass
What can easily happen with wandering spleen?
Torsion
What do patients present with with wandering spleen? (2)
- Acute pain
2. Chronic pain
What will confirm the diagnosis of torsion?
Lack of vascularity
Asplenia
Is a congenital absence of the spleen
What occurs with response to asplenia? (3)
- Impairment of immune response
- Sepsis
- Bacterial meningitis
Polysplenia
More than one spleen
Retrorenal spleen
An anatomical variant in which the inferior portion of the spleen is located behind the upper left kidney
Why are radiologists reluctant to perform splenic intervention procedures?
Because it is highly vascular and they dont want to risk bleeding out
What is used to diagnose abnormalities of the spleen?
Fine needle biopsies
Splenectomy
Complete removal of the spleen
Which is larger, polysplenia or an accessory spleen?
Polysplenule
Core biopsy
Getting a sample of tissue
Needle biopsy
Getting a sample of cells
What may be seen in US when trauma blunt force trauma occurs to the spleen?
Free intra-abdominal fluid
Where is a common place where fluid accumulates after trauma?
Morison’s pouch
Where is Morison’s pouch located between?
The liver and the right kidney
What occurs if the capsule remains intact during trauma? (2)
- Intraparenchymal
2. Subcapsular hematoma
What occurs if the capsule ruptures during trauma? (4)
- Demonstrate fluid in LUQ
- Decreased hematocrit
- May spread through peritoneal cavity
- morison’s pouch and pelvis - A focal or free intraperitoneal hematoma may occur
How does a hematoma look like on US?
Initially it is a liquid appearing-anechoic space, but after the blood clots its echogenicity resembles normal spleen
What can a hematoma mimic?
Splenomegaly
What recuts to easily be able to diagnose hematoma?
Reliquification
Splenic infarction
Occlusion of the splenic vascular supply
What does splenic infarction lead to? (2)
- Ischemia
2. Tissue necrosis
What are 4 complications with splenic infarction?
- Hemorrhage
- Rupture
- Abscess
- Pseudocyst
How does splenic infarction appear on US? (5)
- Peripheral, wedge shaped, hypoechoic
- Echogenicity depends on age of infarct
- Early stages it is anechoic or hypoechoic
- Progresses to hyperechoic-fibrosis
- No flow on colour doppler
Splenomegaly (3)
- Diffuse enlargement
- Capable of growing to an enormous size
- Into left iliac fossa
What measurements are considered splenomegaly?
> 18cm
What are causes of splenomegaly? (5)
- Hematologic
- Rheumatologic
- Infectious
- Congestive
- Infiltrative
What are complications of splenomegaly? (2)
- Hypersplenism
2. Spontaneous rupture
