Spleen Surgery Flashcards
What are 5 functions of the spleen?
- blood filtration and phagocytosis
- immunity against blood-borne antagonists
- blood reservoir
- iron storage
- hematopoiesis
What are 3 indications for total splenectomies?
- solitary/diffuse neoplasia
- torsion
- uncontrolled IMHA
What 3 vessels require ligations prior to taking the spleen out in splenectomies?
- short gastric
- left gastroepiploic
- splenic
What are the 2 methods of ligating vessels in splenectomies?
- ligation of individual hilar vessels - not recommended, very time-consuming
- ligation of major splenic vessels
LDS ligating stapler, hemoclips, or Ligasure can be used
What 3 complications are associated with total splenectomies?
- hemorrhage/bleeders
- pancreatitis or pancreatic necrosis if vascular supply is damaged by aggressive handling
- gastric necrosis if vascular supply to greater curvature is damaged by aggressive handling
When are partial splenectomies indicated? When are they avoided?
preserving splenic function when only part of the organ is destroyed or damaged, commonly with injuries and focal abscesses
neoplasia
How do partial splenectomies compare to total splenectomies?
more technically challenging —> thick capsule is helpful compared to partial liver lobectomies
What are the 5 steps fo partial splenectomies?
- vascular ligation close to hilus
- hold for a few minutes to visualize line of demarcation
- finger tip pressure on the demarcation
- place GI, hemostatic, or vascular forceps along the proposed line of excision
- use mattress suture or staples through splenic parenchyma
Partial splenectomy:
What are siderotic plaques?
deposition of iron or calcium on the surface of the spleen, considered normal with age in dogs (NOT associated with neoplasia)
How is splenomegaly diagnosed?
- abdominal palpation
- radiographs and ultrasounds based on size, position, density, and visceral displacement
- PCV, WBC, platelets
- ultrasound guided FNA/biopsy
What are 3 causes of asymmetrical splenomegaly?
- neoplasia - HSA/hemangioma
- benign splenic nodular hyperplasia - splenoma
- hematoma (trauma)
What are 4 causes of symmetrical splenomegaly?
increased cellularity cause by…
- extramedullary hematopoiesis - regenerative reaction
- neoplasia - MCT in cats
- intravascular disease - Ehrlichiosis
- congestion secondary to torsion or venous occlusion
What is the most common primary tumor of the spleen? What are some other examples?
HSA
- hemangioma
- lymphoma
- sarcoma
- fibrosarcoma
Where do hemangiosarcomas arise from? In what dogs are they most common?
vascular endothelium
older male dogs, especially GSD, Golden Retrievers, Labradors, and Pitbulls