Spleen

Question 1

Sheep farmer with incidental 3cm complex splenic cyst.

next step?

Answer 1

Serologic testing for echinoccocal Abs as tx is partial/total splenectomy and spillage of these paracytic cysts can result in anaphylactic shock

Question 2

52 F s/p lap splenectomy for ITP has gingival bleeding and nosebleeds. Next best step?

Answer 2

sxs due to accessory spleen>?

Send for peripheral smear –find Howell-jolly bodies which are only present in complete ASPLENIA

Question 3

Hodgkin Lymphoma staging

Answer 3

1 - single lymph site
2 - 2 sites above OR below diaphragm
3 - above and below diaphragm
4 - disseminated and involves non lymph organs
B = B sxs

Question 4

ligaments/blood vessels attached to the spleen

Answer 4

gastrosplenic - short gastrics
splenorenal - splenic artery

splenocoloc - retro vessel
splenophrenic - retro vessel

Question 5

The splenic vein is____ and ______ to the pancreas

Answer 5

The splenic vein is posterior and superior to the pancreas – (inf to the splenic artery)

Question 6

MC changes after splenectomy

Answer 6

leukocytosis
thrombocytosis
Howell Jolly bodies

Question 7

MC site for accessory spleen

Answer 7

Splenic hilum
2nd - tail of pancreas
3rd greater momentum

Question 8

12 yo undergoes splenectomy for trauma, 1 yeasr later has cough, SOB, fever. Whats true?

Answer 8

;oss IGM Antibody and complement clearance is pathophysiology of Post-splenectomysepsis

• usually w/i first 2 years
• up to 5% risk
• S pneumo #1

Question 9

Pancreatitis x2, then upper GI bleed w EGD showing varies, whats the definitive management?

Answer 9

Splenectomy – Splenic vein thrombosis after pancreatitis causes gastric varices as collaterals

Question 10

ectopic /wandering spleen in RLQ

Answer 10

careful of torsion which can cause acute ischemia