Spleen (definition, structure, location,types, functions,disease and surgery procedures

What is Spleen?

An organ that is part of the lymphatic system. The spleen makes lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach.

Structure:

The spleen has a slightly oval shape. It is covered by a weak capsule that protects the organ whilst allowing it to expand in size.

The outer surface of the spleen can be anatomically divided into two:

1)Diaphragmatic surface – in contact with diaphragm and ribcage.

2)Visceral surface – in contact with the other abdominal viscera.

It has anterior, superior, posteromedial and inferior borders. The posteromedial and inferior borders are smooth, whilst the anterior and superior borders contain notches.

In enlargement of the spleen (known as splenomegaly), the superior border moves inferomedially, and its notches can be palpated.

The spleen is made up of two basic types of tissue, each with different functions:

1)White pulp

2)Red pulp

1)The white pulp is part of the infection-fighting system (immune system). It produces white blood cells called lymphocytes, which in turn produce antibodies (specialized proteins that protect against invasion by foreign substances).

2)The red pulp filters the blood, removing unwanted material. The red pulp contains other white blood cells called phagocytes that ingest microorganisms, such as bacteria, fungi, and viruses. It also monitors red blood cells, destroying those that are abnormal or too old or damaged to function properly. In addition, the red pulp serves as a reservoir for different elements of the blood, especially white blood cells and platelets (cell-like particles involved in clotting). However, releasing these elements is a minor function of the red pulp.

Spleen has some important functions:

•it fights invading germs in the blood (the spleen contains infection-fighting white blood cells)

•it controls the level of blood cells (white blood cells, red blood cells and platelets)

•it filters the blood and removes any old or damaged red blood cells

Splenectomy:

A splenectomy is a surgical procedure in which all or part of the spleen is removed. The spleen is an organ that sits under rib cage on the upper left side of abdomen. It helps fight infection and filters unneeded material, such as old or damaged blood cells, from the blood.

There are two types of splenectomy:

1)Partial Splenectomy: A partial splenectomy is removal of only a part of the spleen.

2)Total Splenectomy: A total or complete splenectomy is removal of the whole spleen.

Types of spleen removal surgeries:

1)Open Surgery: An incision is made through the center of the belly and the spleen is removed through the incision.

2)Laparoscopic Surgery: Small incisions are made on the belly to allow for the placement of laparoscopic surgical tools and the abdomen is filled/inflated with carbon dioxide. The laparoscopic camera is inserted and the surgeon is able to then remove the spleen with the other laparoscopic tools. Often, four small incisions are made for this procedure, however a larger incision is at times needed

Reasons for a spleen removal:

•)Ruptured spleen. If spleen ruptures due to a severe abdominal injury or because of an enlarged spleen (splenomegaly), the result may be life-threatening, internal bleeding.

•)Enlarged spleen. Splenectomy may be done to ease the symptoms of an enlarged spleen, which include pain and a feeling of fullness.

•)Blood disorder. Blood disorders that may be treated with splenectomy include idiopathic thrombocytopenic purpura, polycythemia vera and thalassemia. But splenectomy is typically performed only after other treatments have failed to reduce the symptoms of these disorders.

•)Cancer. Cancers that may be treated with splenectomy include chronic lymphocytic leukemia, Hodgkin's lymphoma, non-Hodgkin's lymphoma and hairy cell leukemia.

•)Infection. A severe infection or the development of a large collection of pus surrounded by inflammation (abscess) in the spleen may require spleen removal if it doesn't respond to other treatment.

•)Cyst or tumor. Noncancerous cysts or tumors inside the spleen may require splenectomy if they become large or are difficult to remove completely.

Risks of a spleen removal:

Risks of having any major surgery include the following:

•blood loss during the surgery

•allergic reactions or breathing difficulties from anesthesia

•the formation of blood clots

infection

•stroke or heart attack

complications related to splenectomy include:

Blood clot in the vein that carries blood to the liver

Hernia at the incision site

Infection at the incision site

Inflammation of the pancreas (pancreatitis)

Lung collapse

Injury to the pancreas, stomach, and colon:

•formation of a blood clot in the vein that moves blood to your liver

•a hernia at the incision site

•an internal infection

•A collapsed lung

•damage to the organs near your spleen, including the stomach, colon, and pancreas

•a collection of pus under your diaphragm

Open and laparoscopic splenectomies both have risks.