Spleen Flashcards
What type of organ is the spleen?
Peritoneal organ
- located in LUQ between stomach and diaphragm
What is the average size of the spleen?
12 cm long
8 cm trans
4 cm thick
What measurement is considered splenomegaly?
> 12 cm
What other organs are located on the visceral layer of the spleen?
- stomach
- left kidney
- pancreas
- splenic flexure of colon
What is medial and anterior to the spleen?
- pancreatic tail
- fundus of stomach
- lesser sac
What is inferior and medial to the spleen?
:Left kidney
Where can a accessory spleen be found?
- normal congenital variant
- located near the splenic hilum and same echogenicity of the spleen
How does someone get a splenic calcification?
Granulomas are focal lesions resulting from previous infections
What are the most common causes of granulomas?
Histoplasmosis and Tuberculosis
What is a Epidermoid cyst?
Spleen are true cysts lines with squamous epithelium
- average about 10 cm in size
- wall may be calcified
What is a Pancreatic Pseudocyst?
Erode into the spleen due to proximity
What is a benign splenic tumor?
Hemangiomas is most common
Know about malignant splenic tumors…
- uncommon
- mets to spleen followed by breast and lung cancer
- commonly hypoechoic
What is a splenic infarct?
- common in patients with bacterial endocarditis and splenic artery aneurysms
- ** wedge shape hypoechoic lesion
Know about splenic abscess…
- result of sepsis due to endocarditis, dental infections or urosepsis
Know about Sickle Cell Disease…
- spleen begins to be enlarged and remains enlarged due to splenic sequestration (sickle cell pooling) and repeated infarction. Over time, spleen becomes fibrotic and shrinks (autosplenectomy)
What are some most common reasons for splenomegaly?
Congestive : Portal Hypertension and Splenic vein Thrombus
When the spleen enlarges, in what ways does it extend?
- anterior
- medial
- inferior
What is Polycythemia Vera?
Blood disorder resulting in uncontrolled RBC production causing hyperviscosity and hypercoagulation
What may Polycythemia be the cause of?
- Splenomegaly
- Budd-Chiari
- Portal Vein Thrombus
- Splenic Infarcts
What is Heterotaxia (Situs Ambiguous) (Polysplenia / Asplenia)?
right / left transposition of the thoracic or abdominal organs
- due to early embryological disturbances that occur prior to the 6th week gestation
What is Polysplenia?
- left side predominance
- Multiple LUQ spleens
What is Asplenia?
Absent spleen
- reversed positions of the aorta and IVC
Know about splenic trauma…
- subcapsular or intraparenchymal hematomas results when splenic capsule remains intact
What is a perisplenic or intraperitoneal hematoma?
capsule ruptures.
After rupture, fluid is typically demonstrated to be loculated around the spleen
What is a Focused Assessment with Sonography for Trauma (FAST)?
- utilized in the emergency department to document the presence of free fluid in the peritoneal cavity
- appearance of intraperitoneal blood depends on the age, amount and physical state of clot
What can a low Hematocrit show?
Blood spillage outside circulatory system
What is a Ectopic spleen?
- history of splenic rupture or surgery, splenic cells may implant throughout the peritoneal cavity
- occurrence is called Posttraumatic Splenosis
