Spleen
Updates to Article Attributes
The spleen is an organ of the haematological system and has a role in immune response, storage of red blood cells and hematopoiesis.
Gross anatomy
The spleen is a wedge-shaped organ lying mainly in the left upper quadrant (left hypochondrium and partly in the epigastrium) and is protected by the left 9thto 11th ribs. It is soft, highly vascular and dark purple in colour.
Size and weight vary from person-to-person but on average is around 2.5 cm thick, 7.5cm broad and 12.5 cm in length.
The spleen has two poles (superior and inferior), three borders and two surfaces (diaphragmatic and visceral). It is enclosed by a thin capsule, which is easily ruptured.
The spleen is completely covered by peritoneum, except at the hilum, and forms a number of ligaments 6, 7:
- gastrosplenic ligament
- attaches the spleen to the greater curvature of the stomach
- contains short gastric and left gastroepiploic arteries
- splenorenal ligament
- attaches the spleen to the left kidney
- contains splenic artery and vein and the pancreatic tail
Relations
- diaphragmatic surface (superoposteriorly) - dome of the left hemidiaphragm
- visceral surface (anteromedially)
- pancreatic tail
- left kidney and adrenal gland
- stomach
Blood supply
- arterial supply - splenic artery
- venous drainage - splenic vein
Variant anatomy
- ~10% of patients are noted to have an accessory spleen (splenunculus), most commonly in the splenic hilum with a mean size of 10mm 2
- wandering spleen
- polysplenia
- asplenia
- splenogonadal fusion
- retrorenal spleen
Radiographic appearance
Ultrasound
- best assessed in the supine, left lateral position with the left arm placed behind the head
- visualized best obliquely in the 9th or 10th intercostal spaces
- echogenicity usually higher when compared to the liver, but may be iso- or hypo-echoic
CT
- splenic parenchyma should be be assessed in portal venous phase as the heterogeneous contrast-enhancement seen on arterial phase can mimic splenic laceration or contusion 5
-</ul><h5>CT</h5><ul><li>splenic parenchyma should be be assessed in <strong>portal venous phase</strong> as the heterogeneous contrast-enhancement seen on <strong>arterial phase</strong> can mimic <a title="Splenic laceration" href="/articles/splenic-trauma">splenic laceration</a> or contusion <sup>5</sup>- +</ul><h5>CT</h5><ul><li>splenic parenchyma should be be assessed in <strong>portal venous phase</strong> as the heterogeneous contrast-enhancement seen on <strong>arterial phase</strong> can mimic <a href="/articles/splenic-trauma">splenic laceration</a> or contusion <sup>5</sup>
Image 3 CT (C+ arterial phase) ( create )
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