Spleen-Relations-Splenic Enlargement-Trauma to the Spleen

Spleen

The spleen is the largest single mass of lymphoid tissue in the body. It is oval shaped and is reddish and has a notched anterior border.
 It lies just beneath the left half of the diaphragm close to the 9th, 10th, and 11th ribs. The long axis lies along the shaft of the 10th rib, and its lower pole extends forward only as far as the midaxillary line and cannot be palpated on clinical examination .
 The spleen is surrounded by peritoneum, which passes from it at the hilum as the gastrosplenic omentum (ligament) to the greater curvature of the stomach(carrying the short gastric and left gastroepiploic vessels). The peritoneum also passes to the left kidney as the splenicorenal ligament (carrying the splenic vessels and the tail of the pancreas).

 

Relations

■■ Anteriorly: The stomach, tail of the pancreas, and left colic flexure. The left kidney lies along its medial border.

■■ Posteriorly: The diaphragm; left pleura (left costodiaphragmatic recess); left lung; and 9th, 10th, and 11th ribs.

 

Splenic Enlargement

An enlarged spleen extends downward and medially. direct downward enlargement of the organ is prevented by The left colic flexure and the phrenicocolic ligament . As the enlarged spleen projects below the left costal margin, its notched anterior border can be recognized by palpation through the anterior abdominal wall.

The spleen is situated at the beginning of the splenic vein, and in cases of portal hypertension it often enlarges from venous congestion.

Trauma to the Spleen

Although anatomically the spleen gives the appearance of being well protected, automobile accidents of the crushing or run-over type commonly produce laceration of the spleen. Penetrating wounds of the lower left thorax can also damage the spleen.