Spleen Flashcards
location of the spleen
Located in the left upper quadrant between the fundus of the stomach, the diaphragm, the splenic flexure of the left colon and the left kidney
blood supply for spleen
splenic artery
short gastrics
the tail of the pancreas is right near what?
spleen
main 2 functions of the spleen
erythrocyte maintenance
immune function
causes of hypersplenism
Neoplastic disorders
Hematopoietic disorders
Metabolic or storage disorders
antibodies to platelets or RBCS causing spleen to destroy them
diseases associated w/ secondary hypersplenism
Portal HTN Splenic vein thrombosis Leukemias/lymphoma SLE Gaucher disease Mononucleosis Felty syndrome
with primary hypersplenism what is indicated
splenectomy
bleeding of gastric varcies w/ chronic pancreatitis
splenic vein thrombosis (blood can’t get out of the spleen through splenic vein)
what is tx for splenic vein thrombosis
splenectomy
what autoimmune disease requires a splenecomty (if they have warm antibodies)
acquired hemolytic anemia
what meds is acquired hemolytic anemia associated w/
PCN and quinidine
what is first line tx for acquire hemolytic anemia?
glucocorticoids
Antibodies to platelet antigens
No splenomegaly
Petechiae, ecchymosis, epistaxis and easy bruising
ITP Immune/Idiopathic thrombocytopeniaPurpura
when do you tx ITP
moderate or severe purpura
Tx for ITP
glucocorticoids high dose until platelets go to normal
when is splenectomy needed for ITP
people with ITP who fail steroids
do you ever get anyone with ITP platelets?
No
when do you give platelets in a splenectomy for ITP
clamp across splenic artery
common congenital hemolytic anemia
Related to abnormalities in the erythrocyte structure
Affected RBCs have a deficiency in spectrin, an essential component of the cell membrane
hereditary spherocytosis
how can someone w/ hereditary spherocytosis present
w/i first 3 decades
splenomegaly common
can present w/ abdominal discomfort and jaundice
when should a splenectomy be done with ehreditary spherocytosis
at least age 6
also take the gallbladder out
aD trait that results in elliptical erythrocytes increasing rate of destruction of RBC> don’t always need a splenectoy
Hereditory Elliptocytosis
when do you do a splenectomy with a splenic cyst
if persitss or becomes symptomatic
can be from hydatid dz
Relatively rare condition that may follow a splenectomy. Infection is with encapsulated organisms (S pneumonia, H influenza, N meningitidis)
Overwhelming postsplenectomy sepsis (OPSS)
