Spleen Flashcards
Which splenic ligament contains the short gastrics?
Gastrosplenic ligament
Which splenic ligament contains the splenic vessels and tail of the pancreas?
Splenorenal ligament
Red Pulp
Filters damaged red blood cells - More predominant
White pulp
Immune function
Lymphoid follices- B cells
PALS- T cells
Angiographic intervention for splenic injuries?
> Grade III injuries (subcapsular hematoma >50% or expanding, subcapsular hematoma, lacteration >3cm, involving trabecular vessels), contrast blush, moderate hemoperitoneum, ongoing splenic bleeding
Heinz Body
Bite Cells- Intracellular denatured protein
Hereditary spherocytosis is caused by?
Autosomal dominant defect in Spectrin
Howell-Jolly Body
Nuclear remnants of red blood cells
If you don’t see abnormal cells post-splenectomy ?
Accessory spleen
In addition to splenectomy in patients with hereditary spherocytosis, what other procedure do they need?
Cholecystectomy
Indications for splenectomy
Unstable trauma patient, hematologic disorder, splenic abscess, symptomatic cyst, primary malignancy, splenic vein thrombosis
ITP is caused by?
Autoantibodies to glycoprotein IIb/IIIa and Ia/IIa
Most common location for an accessory spleen?
Splenic hilum
Most common source of post-splenectomy bleeding?
Short gastrics
Multi-locoular, thin walled splenic abscess?
Suspect echinococcal, splenectomy
PappenheImer Body
Iron deposits
Primary lymphoid organs
Liver, bone and thymus
Red Pulp
Filters damaged RBC’s
Secondary lymphoid organs
Lymph node, spleen, peyers patches, tonsils
Spurr Cell
Deformed membrane
Systemic vascular resistance is high in which types of shock?
Hypovolemic (low CVP) and cardiogenic (high CVP)
Target Cell
Immature RBC
Thrombotic thrombocytopenic purpura (TTP)
Defective ADAMTS13 -platelet aggregation (Tx= plasmapharesis)
Unilocular thick wall in stable patient splenic abscess treatment?
Percutaneous drainage
When do you transfuse platelets in ITP?
Intraoperative after ligating the splenic artery (prevents consumption of platelets).
When to treat splenic artery aneurysm?
> 2cm, pregnant women or women of child bearing age regardless of age
When to vaccinate patients post-splenectomy?
2 weeks prior to elective splenectomy, 2 weeks post-op (2 weeks prior to discharge)
Which size of cysts need surgical intervention?
> 5cm or symptomatic
Which splenic ligament contains the short gastrics?
Gastrosplenic ligament
Which splenic ligament contains the splenic vessels and tail of the pancreas?
Splenorenal ligament
White pulp
Immune function
Lymphoid follices- B cells
PALS- T cells
Most common benign neoplasm of the spleen
Hemangioma
Fuel source for stomach, enterocytes, pancreas and spleen
Glutamine
Grades of Splenic Injuries
