Answer
1) This is spleen that is enlarged due to cystic mass on the infero-lateral part of it, possibly secondary to infection.
2) The function of spleen includes
- Antibody production
- Initiation of cellular Immune response
- Site of Red blood cell removal
- Platelet storage
3) Blood supply of spleen includes
- Splenic artery (Major supply that divides itself into branches)
- Short gastric artery
- Left Gastro epiploic branches
4) Venous drainage
- It joins together with Superior Mesenteric vein to form Portal vein.
5) Ligaments that supports spleen in place
- Splenogastric ligament
- Splenophrenic ligament
- Splenocolic ligament
- Splenoomental ligament
- Splenorenal ligament.
6) Common causes for removal of spleen includes
- Mostly because of blunt trauma
- Hematological disorder
- Immunological disorder
7) The most common and worrisome complication when spleen is removed is
a) Bacteria sepsis especially due to capsulated bacteria that could lead to death.
- This could be prevented by given vaccination against capsulated bacteria two weeks prior the surgery in elective cases or As soon as possible after the surgery in emergency cases. Vaccination needed includes
i. Streptococcus pneumonia
ii. Haemophilus influenza
iii. Neiserria meningitides
iv. Pneumococcal.
- In patient younger than six years old, he should be given Ampicillin until age 12 years old.
b) Other causes of complication but not really worrisome are post surgical hemorrhage secondary to slipped ligature, left basal atelectasis & pleural effusion and damage to the stomach and pancreas.
Reference
1. Norman S. Williams, Christopher J.K. Bulstrode & R. Ronan O’Connel, “Bailey & Love’s Short Practice of Surgery 25th edition”, Edward Arnold Publisher ltd, 2008
2. Danny O’ Jacobs, “First Exposure General Surgery”, Mc Graw Hill Company, 2007