SPLEEN 1.2 Flashcards
What are some common infections that increase the risk for spontaneous splenic rupture in immunocompromised patients or those with a history of IV drug abuse?
Infectious mononucleosis, malaria, Listeria infection, fungal infections, Dengue, Q fever, lymphoma, angiosarcoma, amyloidosis, and pregnancy.
How does splenic infiltration lead to a risk of spontaneous splenic rupture?
Infiltration of the splenic parenchyma leads to a thin capsule, increasing the risk of rupture.
What are the common organisms involved in splenic abscesses?
Aerobes such as Streptococci and Escherichia coli.
How do splenic abscesses present clinically?
Fever, left upper quadrant pain, leukocytosis, and splenomegaly.
What is the first-line diagnostic tool for detecting splenic abscesses?
Ultrasound or CT scan.
How long is the typical antibiotic treatment for a splenic abscess?
At least 14 days.
What is the primary surgical treatment for splenic abscesses in unstable patients?
Splenectomy.
What is the difference between a parasitic cyst and a pseudocyst in the spleen?
A parasitic cyst, typically from Echinococcus species, has an epithelial lining, while a pseudocyst is a result of trauma and lacks an epithelial lining.
How is a symptomatic parasitic cyst in the spleen treated?
Symptomatic parasitic cysts are treated with splenectomy while avoiding spillage of cyst content to prevent anaphylactic shock.
What is the most common cause of non-parasitic cysts in the spleen?
Dermoid, epidermoid, and epithelial cysts.
How are non-parasitic splenic cysts managed if symptomatic?
Symptomatic non-parasitic cysts can be treated laparoscopically or surgically depending on the size, with excision and splenic preservation for small cysts.
What is the mechanism of splenic artery aneurysms?
Splenic artery aneurysms arise from the middle to distal portion of the splenic artery, often due to trauma or other vascular abnormalities.
What are the indications for treating a splenic artery aneurysm?
Presence of symptoms, pregnancy, intention to become pregnant, and presence of pseudoaneurysms with inflammatory processes.
What is the management approach for a mid-splenic artery aneurysm?
Resection or ligation of the aneurysm, and splenectomy if the splenic artery is ligated.
What is the cause of splenomegaly in portal hypertension?
Portal hypertension due to liver cirrhosis leads to splenomegaly and splenic congestion, causing sequestration and destruction of circulating cells in the spleen.
How is sinistral hypertension, secondary to splenic vein thrombosis, treated?
Sinistral hypertension is curable with splenectomy.
What are the components of Felty’s syndrome?
Felty’s syndrome is characterized by rheumatoid arthritis, splenomegaly, and neutropenia.
What is the primary treatment for Felty’s syndrome?
Splenectomy and treatment for the underlying rheumatoid arthritis.
What causes a wandering spleen?
A wandering spleen is caused by congenital problems, leading to a spleen that ‘floats’ inside the abdominal cavity without attachment to adjacent viscera.
What complication can arise from a wandering spleen?
Splenic torsion and infarction, leading to severe abdominal pain and the need for splenopexy or splenectomy.
What are the key preparations for a patient undergoing splenectomy?
Vaccination against pneumococcus, meningococcus, and Haemophilus, transfusion for anemic patients, and availability of cross-matched blood.
How should an anemic patient be prepared before splenectomy?
Anemic patients should be transfused to a hemoglobin level of 10 g/dL before surgery.
How are DVTs prevented in splenectomy patients?
DVT prophylaxis includes the use of sequential compression devices and subcutaneous heparin administration.
What is the most common indication for open splenectomy (OS)?
Traumatic rupture of the spleen.
