Chapter 70 The Spleen

Fetal splenic tissue develops from condensations of mesoderm in the dorsal mesogastrium. This peritoneal fold attaches the dorsal body wall to the fusiform swelling in the foregut that develops into the stomach. The weight of the normal adult spleen is 75–250 g and it measures up to 10 × 7 × 3 cm. It lies in the left hypochondrium between the gastric fundus and the left hemidiaphragm, with its long axis lying along the 10th rib. Although the spleen was previously thought to be dispensable, it is now recognised that an incidental splenectomy during the course of another operative procedure increases the risk of complications and death. The surgeon should therefore normally endeavour to preserve the spleen to maintain the following functions: immune function; filter function; pitting; reservoir function; and cytopoiesis. Splenic agenesis is rare but is present in 5% of children with congenital heart disease. Polysplenia is a rare condition resulting from failure of splenic fusion.

Advanced Learning Content
Chapter 70: The Spleen
Multiple Choice Questions
Weblinks

Journal articles

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3674676/ (free)

Incidence of venous thromboembolism and sepsis in patients with immune thrombocytopenia after splenectomy.

https://www.sciencedirect.com/science/article/abs/pii/S0140673610614936?via%3Dihub/ (paid)

More about post splenectomy state and hypersplenism.

https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.21501/ (free)

Read about short-term and long-term failure of laparoscopic splenectomy in adult patients with immune (idiopathic) thrombocytopenic purpura.

https://academic.oup.com/bjs/article/95/3/273/6156254/ (free)

Current protocols for the vaccination of asplenic or hyposplenic adults.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716836/ (free)

Read about non-cirrhotic portal fibrosis/idiopathic portal hypertension: Asian Pacific Association for the Study of the Liver recommendations for diagnosis and treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2125973/pdf/9056802.pdf/ (free)

All about the hereditary anaemias.

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