What are the functions of spleen?
Spleen is the largest lymphoid (haemolymphoid) organ. Its main functions are:
- To remove worn out RBCs.
- To remove microbial agents from the circulation.
- To produce RBCs in fetal.
- To provide resistance to the body.
Describe the location and gross features of spleen.
Location:
- It is located in the left hypochondrium between the fundus of stomach and diaphragm.
- Lies opposite to 9th -11th ribs
- Its long axis is parallel to the 10th
- Its anterior end does not extend beyond midaxillary line.
Shape: Is tetrahedral/ovoid in shape.
Size: Length -12cm, Width – 7cm, Thickness – 3cm, Weight – 150-200gms.
Gross features: spleen has:
- Two surfaces: diaphragmatic and visceral
- Three borders: superior, inferior and intermediate
- Two ends: anterior and posterior
Applied Aspect
Normal spleen is not palpable
Only when it enlarges twice its normal size, it can be palpated under the left costal margin on inspiration.
- Splenomegaly (enlarged spleen): Causes include malaria, typhoid fever, hemolytic anemia.
- Enlarged spleen grows downwards and medially towards the right iliac fossa, because phrenicocolic ligament prevents downward extent towards left iliac fossa.
Describe the relations of spleen.
Relations of diaphragmatic surface
It is related to
- left costodiaphramatic recess
- left lung
- diaphragm and
- 9th to 11th
Relations of visceral surface
It is related to the following viscera:
- Fundus of stomach
- Left kidney
- Left colic flexure
- Pancreas
- Visceral surface bears hilum through which splenic vessels enter the spleen. Lienorenal and gastrosplenic ligaments are attached to the hilum.
Name the peritoneal folds attached to the hilum and their contents.
Two peritoneal folds are attached to the hilum of spleen.
Gastrosplenic ligament:
- Extends from hilum of spleen to the greater curvature of stomach.
- Contains short gastric arteries
Lienorenal ligament:
- Extends from the hilum of spleen to the left kidney.
- Contains splenic vessels and tail of pancreas.
Applied Aspect
Close relationship of the tail of pancreas to the hilum of spleen
The close relationship of the tail of pancreas to the hilum of spleen and splenic vessels has to be kept in mind during splenectomy as it may be easily wounded. Enzymes released from the severed pancreas may digest the surrounding tissues. Secondly the tail contains maximum number of Islet of Langerhan’s and injury to it may cause diabetes mellitus.
Accessory spleens
May occur near the hilum, in the tail of pancreas, omentum, mesentery of small intestine, ovary or testis. While performing splenectomy all accessory spleen should be located and excised, otherwise the symptoms of the disease will persist.