Spleen

Abstract

Studies indicate that the majority of the population has two splenic segments—superior and inferior. However, three and more segments have been reported in the literature. Splenic vasculature is segmental and highly variable. The splenic veins follow the pattern of the arterial distribution more consistently in the smaller branches than in the larger ones.

Splenectomy is usually performed for hemorrhage, hypersplenism, Hodgkin’s disease staging, or a problem such as an abscess, cyst, or tumor. Detailed step-by-step procedure is presented for splenectomy, ligation of the splenic pedicle, and occlusion of the splenic artery. An expanded section on laparoscopic splenectomy highlights the “leaning spleen” technique. Patients with fractures of the left 9–11th ribs should be observed closely for splenic rupture. A healthy ruptured spleen can be delivered easily from the abdomen; a large, diseased spleen requires careful dissection.