Spleen

Question 1

What type of organ is the spleen?

Answer 1

Peritoneal organ

- located in LUQ between stomach and diaphragm

Question 2

What is the average size of the spleen?

Answer 2

12 cm long
8 cm trans
4 cm thick

Question 3

What measurement is considered splenomegaly?

Answer 3

> 12 cm

Question 4

What other organs are located on the visceral layer of the spleen?

Answer 4

• stomach
• left kidney
• pancreas
• splenic flexure of colon

Question 5

What is medial and anterior to the spleen?

Answer 5

• pancreatic tail
• fundus of stomach
• lesser sac

Question 6

What is inferior and medial to the spleen?

Answer 6

:Left kidney

Question 7

Where can a accessory spleen be found?

Answer 7

• normal congenital variant

- located near the splenic hilum and same echogenicity of the spleen

Question 8

How does someone get a splenic calcification?

Answer 8

Granulomas are focal lesions resulting from previous infections

Question 9

What are the most common causes of granulomas?

Answer 9

Histoplasmosis and Tuberculosis

Question 10

What is a Epidermoid cyst?

Answer 10

Spleen are true cysts lines with squamous epithelium

• average about 10 cm in size
• wall may be calcified

Question 11

What is a Pancreatic Pseudocyst?

Answer 11

Erode into the spleen due to proximity

Question 12

What is a benign splenic tumor?

Answer 12

Hemangiomas is most common

Question 13

Know about malignant splenic tumors…

Answer 13

• uncommon
• mets to spleen followed by breast and lung cancer
• commonly hypoechoic

Question 14

What is a splenic infarct?

Answer 14

• common in patients with bacterial endocarditis and splenic artery aneurysms
• ** wedge shape hypoechoic lesion

Question 15

Know about splenic abscess…

Answer 15

• result of sepsis due to endocarditis, dental infections or urosepsis

Question 16

Know about Sickle Cell Disease…

Answer 16

• 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)

Question 17

What are some most common reasons for splenomegaly?

Answer 17

Congestive : Portal Hypertension and Splenic vein Thrombus

Question 18

When the spleen enlarges, in what ways does it extend?

Answer 18

• anterior
• medial
• inferior

Question 19

What is Polycythemia Vera?

Answer 19

Blood disorder resulting in uncontrolled RBC production causing hyperviscosity and hypercoagulation

Question 20

What may Polycythemia be the cause of?

Answer 20

• Splenomegaly
• Budd-Chiari
• Portal Vein Thrombus
• Splenic Infarcts

Question 21

What is Heterotaxia (Situs Ambiguous) (Polysplenia / Asplenia)?

Answer 21

right / left transposition of the thoracic or abdominal organs
- due to early embryological disturbances that occur prior to the 6th week gestation

Question 22

What is Polysplenia?

Answer 22

• left side predominance

- Multiple LUQ spleens

Question 23

What is Asplenia?

Answer 23

Absent spleen

- reversed positions of the aorta and IVC

Question 24

Know about splenic trauma…

Answer 24

• subcapsular or intraparenchymal hematomas results when splenic capsule remains intact

Question 25

What is a perisplenic or intraperitoneal hematoma?

Answer 25

capsule ruptures.

After rupture, fluid is typically demonstrated to be loculated around the spleen

Question 26

What is a Focused Assessment with Sonography for Trauma (FAST)?

Answer 26

• 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

Question 27

What can a low Hematocrit show?

Answer 27

Blood spillage outside circulatory system

Question 28

What is a Ectopic spleen?

Answer 28

• history of splenic rupture or surgery, splenic cells may implant throughout the peritoneal cavity
• occurrence is called Posttraumatic Splenosis