Normal spleen. Ectopic position of the spleen:- Left flank Pelvis Posterior to the left kidney.
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Transcript of Normal spleen. Ectopic position of the spleen:- Left flank Pelvis Posterior to the left kidney.
Normal spleen
Splenic variantEctopic position of the spleen-:
Left flank Pelvis Posterior to the left kidney
Splenic variantSplenunculi( accessory spleen )• Small ectopic nodule of splenic tissue usually situated near the hilum of the spleen.• Recieves its blood supply from splenic arterySonogrphically • Appears as well defined oval or rounded exceed 4 cm in diameter • Has a normal splenic acoustic characteristics • Not visible on ultrasound unless splenomegaly is present • A splenunculus may enlarge in post splenectomy patients
Pathology of the spleen
Splenomegally • Enlargement of the spleen is a highly non specific sign associatede with numerous conditions as • Infection due to rubella • Portal hypertension , • Neoplastic conditions as lymphoma • The aetiology of splenomegaly can not be usually detected on ultrasound
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Splenomegally • Enlargment of the spleen is considered when its long axis exceeds 12 cm• The spleen enlarges downwards and medially • Its inferior margin becomes rounded and may extend below the left kidney.
Benign splenic conditions
Splenic cysts Types of splenic cysts • Simple cysts• Post traumatic cysts ( liquefied haematoma )• Hydatid cyst • Cystic metastasis
Haemangioma • Rare in the spleen• Usually well defined hyperechoic focal lesion , rarely contain cystic areas
Splenic abscess • Uncommon
Causes: -• Amoebic or fungal infection• Blood born bacterial infection• Post traumatic
Splenic abscess Clinical presentation:-
upper abdominal pain and fever
Ultrasound appearance-: Similar to liver abscess
Splenic calcification• Calcifications may occur in old inactive abscess cavities• Associated with traumatic injury • In old resolving post traumatic haematoma
Splenic trauma • Splenic laceration is not usually detect by US especially in the immediate post- trauma phase• The laceration appears sonographically as hyperechoic line within the spleen • A frank area of haemorrhag may be detected
Splenic trauma
Malignant splenic diseases
Lymphoma • The most common malignant disease affecting the spleen
Clinical features-: • Anaemia • General fatigue• Weight loss• Fever • Sweating • Infection and decressed immunity
Lymphoma Ultrasound appearance :-• In many cases there is no sonographic abnormalities• Diffuse splenic enlargement with normal , hypo- or hyperechogenicity • Single or multiple and of varying sizes hypoechoic , anechoic , hyperechoic or mixed echogenicity • Lymphadenopathy may be seen elsewhere in the abdomen
Metastases Metastases occurs in the spleen much less commonly than in the liver
Sonographic appearance :-As in the liver
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