Spleen

Spleen

• 1.
  Normal Physiology &Disorders SPLEEN @ W I N N E R Z K L U B
• 2.
   Spleen isan encapsulated organ weighing 100-150g in adult  Situated in the LUQ of the abdomen, mostly concealed by the lower ribs.  Serves two functions: it is a lymphoid organ, and it has a great capacity for phagocytosing particulate material in the circulation.  The lymphoid function occurs in the white pulp & the phagocytic activity resides in the red pulp. NORMAL PHYSIOLOGY: @ W I N N E R Z K L U B
• 3.
  The term isapplied to the association between a peripheral blood pancytopenia & splenic enlargement. It may be primary or secondary to a wide variety of pathological processes. Primary hypersplenism is a poorly understood condition of unknown etiology 1° is characterised by marked & often massive splenomegaly & pancytopenia. 2° splenomegaly may also be associated with hypersplenism. HYPERSPLENISM @ W I N N E R Z K L U B
• 4.
  Many causes, includingvascular congestion, inflammatory & reactive disorders, leukaemias & lymphomas, & storage disorders. Enlarged spleen may rupture after only minor trauma. 2° splenomegaly may result in hypersplenism. The causes of 2° splenomegaly include: • Congestion • Infection • Immune disorders • 1° or metastatic neoplasms • Storage disorders • Amyloidosis SPLENOMEGALY @ W I N N E R Z K L U B
• 5.
  Splenic infarction followsocclusion of the splenic artery or its branches & is usually 2° to emboli that arise in the heart. Occasionally, splenic infarction may be due to local thrombosis, as in sickle cell disease, myeloproliferative disorders & malignant infiltrates. SPLENIC INFARCTION @ W I N N E R Z K L U B
• 6.
  Usually caused byblunt abdominal trauma, particularly automobile accidents. Massive, life-threatening intraperitoneal haemmorhage may follow rupture, necessitating emergency splenectomy. Spontaneous rupture may occur, particularly in infectious mononucleosis & in spleens enlarged by haemopoietic proliferations such as myelofibrosis. SPLEEN RUPTURE @ W I N N E R Z K L U B
• 7.
  May occur inassociation with intestinal malabsorption states such as coeliac disease. Spleen is small & weighs <50g. Evidence of hyposplenism with numerous target cells & Howell-Jolly inclusion bodies in red cells. Patients with sickle cell disease suffer multiple splenic infarcts & the spleen is greatly reduced in size & function. SPLENIC ATROPHY @ W I N N E R Z K L U B