1887

The spleen

image of The spleen
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Abstract

The normal spleen in dogs is an elongated flattened organ, which is triangular in cross section. In cats it is more ovoid in cross section. The spleen is located in the left hypogastric region and has dorsal (‘head’) and ventral (‘tail’) extremities. The head of the spleen is located in the dorsal cranial left abdomen, attached to the fundus of the stomach by the gastroepiploic ligament, through which the left gastroepiploic and short gastric arteries and veins course.The body and tail of the spleen exhibit greater mobility, are usually very superficial, and variably located in the mid-to ventral abdomen. On ventrodorsal (VD) radiographs, the head of the spleen is seen as a triangular soft tissue opacity along the left body wall, caudal and lateral to the fundus of the stomach and cranial to the left kidney, in both the dog and cat. The cranial-caudal position may change depending on body position, degree of distension of the stomach and splenic size. On the VD view, the body and tail of the spleen may be oriented parallel to the long axis of the body, adjacent to the left lateral body wall, or to the right, perpendicular to the long axis of the body. Often the body and tail regions are poorly visualized due to superimposition with other structures. The following are addressed: Normal radiographic anatomy; Ultrasonography; Overview of additional imaging modalities; and Splenic diseases.

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Figures

Image of 14.1
14.1 The normal spleen (arrowed) can be seen on the VD radiograph in both the dog and the cat. The head and body of the spleen are seen in the dog on this view, whilst the entirety of the spleen is seen along the left lateral body wall in the cat.
Image of 14.2
14.2 Lateral radiograph of a dog showing the normal body and tail of the spleen (arrowed) caudal to the stomach and liver.
Image of 14.3
14.3 Lateral radiograph showing diffuse splenomegaly in a dog. The body and tail of the spleen (arrowed) are increased in thickness and show rounding of the margins. The enlarged head of the spleen (arrowheads) results in increased opacity in the dorsocranial abdomen. The intestines are displaced in a dorsal and caudal direction. Lateral radiograph showing diffuse splenomegaly in a cat. Normally, the body and tail of the spleen (arrowed) are not visible in the cat. The enlargement of the head of the spleen (arrowheads) is identified by the increased soft tissue opacity in the dorsocranial abdomen.
Image of 14.4
14.4 Lateral radiograph of a dog showing irregularity of the splenic margins (arrowed).
Image of 14.5
14.5 Ultrasonogram of the spleen in a normal dog. The splenic parenchyma (arrowed) is uniform in echotexture and hyperechoic relative to the kidney cortex. Ultrasonogram of the normal spleen in a cat. The splenic capsule is easily visible in the near-field (arrowed) and the splenic veins can be seen close to the hilus (arrowheads).
Image of 14.6
14.6 Ultrasonograms of the spleen in a normal dog showing a splenic vein without and with colour Doppler examination.
Image of 14.7
14.7 CT image of the cranial abdomen of a dog that was anaesthetized with thiopental. The spleen (arrowed) is enlarged and hyperattenuating compared with the right kidney (RK). (Window width = 300 HU, window level = 50 HU)
Image of 14.9
14.9 An 11-year-old mixed breed dog sedated with acepromazine prior to abdominal radiography. The spleen (arrowed) is diffusely enlarged noted by increased thickness and rounding of the margins. This has resulted in dorsal and caudal displacement of the intestines on the lateral view and medial displacement of the small intestines on the VD view.
Image of 14.10
14.10 Abdominal radiographs of a 4-year-old Belgian Tervuren presented with a 4-day history of lethargy, depression and anorexia. Serosal detail is poor throughout the abdomen. There is a reverse C-shaped soft tissue opacity in the mid-abdomen (arrowed) on the lateral view. On the VD view there are loops of small intestine (arrowed) occupying the region normally occupied by the head of the spleen. Splenic torsion was confirmed during abdominal exploratory surgery.
Image of 14.11
14.11 Radiographs of an 8-year-old German Shepherd Dog showing multifocal small gas pockets within the right mid- to caudal abdomen. There is diffuse loss of serosal detail and the intestines are displaced away from the abnormal gas-filled structure (arrowed). Splenic torsion with necrosis was diagnosed.
Image of 14.12
14.12 Colour Doppler ultrasonograms from two dogs with splenic torsion. Typical hypoechoic, lacy parenchymal appearance of the spleen. The spleen has a more uniform echogenicity, but no flow was identified in the splenic vessels.
Image of 14.13
14.13 Ultrasonograms of a dog with a splenic infarct. There is a sharp line of demarcation (arrowed) between the normal hyperechoic splenic parenchyma and the hypoechoic infarcted region. With colour Doppler evaluation, lack of blood flow is noted in the infarcted area.
Image of 14.14
14.14 A small focal splenic head mass (arrowed) was only visible on the VD view in this dog. Due to the small size of the mass there was minimal displacement of the colon and small intestines. A large mass involving the head and body of the spleen, resulting in caudal and rightward displacement of the small and large intestines.
Image of 14.15
14.15 Splenic haemangiosarcoma involving the body and tail of the spleen is seen as a ventral mass (arrowed) on the lateral view, resulting in caudal and dorsal displacement of the intestines. On the VD view, the mass (arrowed) is central and to the left of midline, resulting in rightward and caudal displacement of the small intestines.
Image of 14.16
14.16 A well circumscribed splenic haematoma present in the ventral mid-abdomen (arrowed). The normal spleen can be seen (SPLEEN) and is confluent with the haematoma (MASS). A small amount of anechoic abdominal fluid (arrowed) is also visible.
Image of 14.17
14.17 A 10-year-old Labrador Retriever diagnosed with splenic haemangiosarcoma. A well circumscribed mass (arrowed) is present in the ventral mid-abdomen on lateral and VD radiographs. The mass was of mixed echogenicity with hyperechoic, hypoechoic and anechoic regions being identified on ultrasound examination. Note the similarity in appearance of the radiographs in this dog with neoplastic disease compared with a dog with benign disease (see Figure 14.16 ).
Image of 14.18
14.18 Radiographs from a dog with splenic haemangiosarcoma and haemoabdomen. The splenic margins are not well defined due to the loss of abdominal serosal detail. A mass effect is present due to the caudal displacement of the small intestines (arrowed).
Image of 14.19
14.19 Lateral radiograph of a dog diagnosed with multicentric lymphoma. VD radiograph of a dog diagnosed with multicentric lymphoma. The spleen is diffusely enlarged (arrowed). Small hypoechoic nodules are noted throughout the splenic parenchyma on ultrasonography.
Image of 14.20
14.20 A 13-year-old Domestic Shorthaired cat with lymphoma of the spleen and intestines. The spleen (arrowed) is visible on the lateral view, which denotes splenomegaly in the cat. Mineralization of the peritoneal fat (arrowhead) is also seen near the spleen. On the VD view, the margins of the spleen are difficult to visualize, but the left kidney (arrowed) is caudally displaced by the enlarged spleen. Ultrasonogram showing the spleen is diffusely hypoechoic and mottled in echogenicity.

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