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Spleen
- 1. Universidad de Guadalajara Centro Universitario Ciencias de la Salud Spleen Giovanna Lazcano Sherman Dr. Héctor Manuel Virgen Ayala November 2011 Dr. Benjamín Robles Mariscal
- 2. Anatomy Develops from mesenchymal cells in the dorsal mesogastrium during the fifth week of gestation.
- 4. The peritoneum coveringthe spleen, except in the hilum.
- 5. 7cm 150 gr. (80 -300 gr). 12 cm 3 – 4 cm
- 6. Ligaments • Gastrosplenic • Splenophrenic • Splenorenal • Splenocolic
- 7. Irrigation and venousdrainage
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- 12. Cronic Lymphocytic Leukemia Is a B-cell leukemia that is characterized by the progressive accumulation of relatively mature, but functionally incompetent, lymphocytes. Splenectomy for palliation of symptomatic splenomegaly and for treatment of cytopenia related to hypersplenism
- 13. Hairy cell leukemia Splenomegaly, pancytopenia , and neoplastic mononuclear cells in the peripheral blood and bone marrow Administration of purine analogues, as initial treatment. Splenectomy…massive enlargement of the spleen or with evidence of hypersplenism.
- 14. Myelodysplastic syndrome The bone marrow is usually replaced by fibrous tissue. Splenectomy ... * Hemolysis unresponsive to treatment. * Symptoms esoplenomegalia graces of mass. * Life-threatening thrombocytopenia.
- 15. Systemic mast celldisease indolent aggressive Splenectomy (thrombocytopenia)
- 16. Gaucher disease Autosomal recessive disorder caused by a deficiency of beta-glucosidase. (an enzyme that degrades the sphingolipid glucocerebroside) Splenectomy for hypersplenism-related pancytopenia. (leaving a remnant)
- 17. Wiskott-Aldrich syndrome A X-linkedrecessive disease characterized by eczema, thrombocytopenia (20,000 – 40,000) immune deficiency, and bloody diarrhea (secondary to the thrombocytopenia). Splenectomy normalizes the shape, size and function of platelets. (Increased survival).
- 18. Sarcoidosis Granulomatous disease of unknown origin. Splenectomy for hypersplenism- related pancytopenia.
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- 20. Hereditary spherocytosis Hemolytic anemia, the deficiency of membrane proteins (spectrin, ankyrin and protein 4-2) Characterized by sphere-shaped red blood cells.
- 21. Hereditary elliptocytosis Only 10%are symptomatic Splenectomy
- 22. Hereditary nonspherocytic hemolytic anemia. • Anaerobic metabolism (energy). • Production of antioxidants (glutathione) Splenectomy is not curative but improve some conditions.
- 23. Immune hemolytic anemia • IgM • IgG Splenectomy
- 24. Immune Thrombocytopenic Purpura IGg fibrinogen receptor
- 25. Treatment Mild symptoms orasymptomatic ... not require specific treatment. Corticosteroids. Splenectomy
- 26. Felty’s syndrome Rheumatoid arthritis Neutropenia Splenomegaly IgG
- 27. Trombotic trombocitopenic purpura • Fever Plasmapheresis • Thrombocytopenic purpura Splenectomy • Hemolytic anemia • Neurologic manifestations • Renal failure
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- 30. 5. Cysts, abscesses andprimary splenic tumors.
- 31. Cysts Rx calcification in the cyst wall Primary Splenic tumors Abscesses • Lymphoma 40-100% mortality • Sarcoma Rx Presence of gas in the spleen • Hemangioma (pathognomonic) • Hamartoma CT Diagnostics
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- 33. Single lesions ofthe spleen Malignant lesions 60% Benign lesions 40%
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- 37. Splenectomy most common... 40 - 50% Hematologic disorders. 35 - 40% Trauma. 20 -30% Neoplastic disease. Immune Thrombocytopenic Purpura has the highest incidence