1887

fThe spleen

image of The spleen

Abstract

Surgical conditions of the spleen are commonly encountered in small animal practice. In some instances splenic biopsy or partial splenectomy may be warranted, but in most cases splenectomy is the treatment of choice. This chapter looks at anatomy, surgical techniques, splenic conditions and postoperative considerations. Practical tips and potential complications are highlighted throughout. Splenic biopsy and partial splenectomy; Splenectomy.

Loading full text...

Full text loading...

/deliver/fulltext/10.22233/9781910443248/9781910443248.12.html?itemId=/content/chapter/10.22233/9781910443248.chap12&mimeType=html&fmt=ahah
/content/chapter/10.22233/9781910443248.chap12

Figures

12.1 Gastrosplenic ligament containing the short gastric arteries and veins.
12.2 Siderotic plaques on the tail of the spleen.
12.3 The blood supply to the spleen. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
12.4 (a) Diffuse splenomegaly due to an undifferentiated sarcoma. (b) Focal splenomegaly due to a splenic haemangiosarcoma.
12.7 Ultrasonographic appearance of a splenic haemangiosarcoma.
12.8 CT scan showing a large splenic mass localized to one end of the spleen (arrowed).
12.9 Splenic torsion. (a) Ventrodorsal abdominal radiograph of a dog with splenic torsion. Note the C-shaped spleen (arrowed). (b) Splenic pedicle; note the ‘corkscrew’ appearance.

(b, Courtesy of S Birchard)

12.10 Wedge-shaped splenic infarct.
12.11 Metastasis of haemangiosarcoma to the omentum.
12.14 Omental adhesions to a splenic haemangiosarcoma.
The portion of spleen to be removed is identified and the transection line is visualized. The portion of spleen to be removed is identified and the transection line is visualized.
The cut surface of the spleen is oversewn with a continuous suture pattern. Alternatively, a double row of overlapping horizontal mattress sutures can be placed just proximal to the cut edge to ensure haemostasis. The cut surface of the spleen is oversewn with a continuous suture pattern. Alternatively, a double row of overlapping horizontal mattress sutures can be placed just proximal to the cut edge to ensure haemostasis.
The vessels supplying the portion of the spleen to be removed are ligated and divided. Crushing forceps are placed across the tissue to be removed and atraumatic forceps (such as Doyen forceps) are placed across the remaining portion of the spleen. The spleen is then divided between the two pairs of forceps. The vessels supplying the portion of the spleen to be removed are ligated and divided. Crushing forceps are placed across the tissue to be removed and atraumatic forceps (such as Doyen forceps) are placed across the remaining portion of the spleen. The spleen is then divided between the two pairs of forceps.
Metastasis of a splenic haemangiosarcoma to the diaphragm. Metastasis of a splenic haemangiosarcoma to the diaphragm.
Close-up view. Close-up view.
Curved forceps are used to dissect the vessels along the hilus of the spleen. Curved forceps are used to dissect the vessels along the hilus of the spleen.
A ligate-and-divide stapler being used for a splenectomy. A ligate-and-divide stapler being used for a splenectomy.
The stapler has fired two C-shaped staples (arrowed) and divided between them. The stapler has fired two C-shaped staples (arrowed) and divided between them.
Use of a ligate-and-divide stapler for complete splenectomy. Use of a ligate-and-divide stapler for complete splenectomy.

References

  1. Brockman DJ , Mongil CM , Aronson LR and Brown DC (2000) A practical approach to haemoperitoneum in the dog and cat. Veterinary Clinics of North America: Small Animal Practice 30 , 657668 [Crossref]
    [Google Scholar]
  2. Brown NO (1985) Hemangiosarcoma. Veterinary Clinics of North America: Small Animal Practice 15 , 569575 [Crossref]
    [Google Scholar]
  3. Brown NO , Patnaik AR and MacEwen EG (1985) Canine hemangiosarcoma: retrospective analysis of 104 cases. Journal of the American Veterinary Medical Association 186 , 5658
    [Google Scholar]
  4. Day MJ , Lucke VM and Pearson H (1995) A review of pathological diagnoses made from 87 canine splenic biopsies. Journal of Small Animal Practice 36 , 426433 [Crossref]
    [Google Scholar]
  5. Dye T (2003) The acute abdomen: a surgeon’s approach to diagnosis and treatment. Clinical Techniques in Small Animal Practice 18 , 5365 [Crossref]
    [Google Scholar]
  6. Eberle N , von Babo V , Nolte I , Baumgartner W and Betz D (2012) Tierärztliche Praxis . Ausgabe K, Kleintiere/Heimtiere 40, 250260
    [Google Scholar]
  7. Hammond TN and Pesillo-Crosby SA (2008) Journal of the Veterinary Medical Association 232, 553558
    [Google Scholar]
  8. Hardie EM , Vaden SL , Spauling K and Malarkey DE (1995) Splenic infarction in 16 dogs: a retrospective study. Journal of Veterinary Internal Medicine 9 , 141148 [Crossref]
    [Google Scholar]
  9. Khalaj A , Bakhtiari J and Niasari-Naslaji A (2012) Comparison between single and three portal laparoscopic splenectomy in dogs. BMC Veterinary Research 8 (1), 161 [Crossref]
    [Google Scholar]
  10. King L and Boag A (2007) BSAVA Manual of Canine and Feline Emergency and Critical Care , 2nd edn. BSAVA Publications, Gloucester
    [Google Scholar]
  11. Ledgerwood AM and Lucas CE (2003) A review of studies on the effects of hemorrhagic shock and resuscitation on the coagulation profile. Journal of Trauma: Injury, Infection, and Critical Care 54 , S68S74
    [Google Scholar]
  12. MacEwen EG (2001) Miscellaneous tumours: hemangiosarcoma. In: Small Animal Clinical Oncology , 3rd edn, ed. SJ Withrow and EG MacEwen, pp.295297. Lea and Febiger, Philadelphia
    [Google Scholar]
  13. Marino DJ , Matthiesen, Fox PR , Lesser MB and Stamoulis ME (1994) Ventricular arrhythmias in dogs undergoing splenectomy: a prospective study. Veterinary Surgery 23 , 101106 [Crossref]
    [Google Scholar]
  14. Mazzaferro EM (2003) Triage and approach to the acute abdomen. Clinical Techniques in Small Animal Practice 18 , 16 [Crossref]
    [Google Scholar]
  15. Neath PJ , Brockman DJ and Sanders HM (1997) Retrospective analysis of 19 cases of isolated torsion on the splenic pedicle in dogs. Journal of Small Animal Practice 38 , 387392 [Crossref]
    [Google Scholar]
  16. Patsikas MN , Rallis T , Kladakis SE and Dessitis AK (2001) Computed tomography diagnosis of isolated splenic torsion in a dog. Veterinary Radiology and Ultrasound 42 , 235237 [Crossref]
    [Google Scholar]
  17. Radhakrishnan A and Mayhew PD (2013) Laparoscopic splenic biopsy in dogs and cats: 15 cases (2006–2008). Journal of the American Animal Hospital Association 49 (1), 4145 [Crossref]
    [Google Scholar]
  18. Rivier P and Monnet E (2011) Use of a vessel sealant device for splenectomy in dogs. Veterinary Surgery 40 (1), 102105 [Crossref]
    [Google Scholar]
  19. Spangler WL and Kass PH (1997) Pathologic factors affecting post splenectomy survival in dogs. Journal of Veterinary Internal Medicine 11 , 166171 [Crossref]
    [Google Scholar]
  20. Waldron DR and Robertson J (1995) Partial splenectomy in the dog: a comparison of stapling and ligation techniques. Journal of the American Animal Hospital Association 31 , 343348 [Crossref]
    [Google Scholar]
  21. Walters DJ , Caywood DD , Hayden DW and Klausner JS (1988) Metastatic pattern in dogs with splenic haemangiosarcomas: clinical implications. Journal of Small Animal Practice 29 , 805814 [Crossref]
    [Google Scholar]
  22. Weinstein MJ , Carpenter JL and Schunk CJ (1989) Nonangiogenic and nonlymphomatous sarcomas of the canine spleen: 57 cases (1975–1987). Journal of the American Veterinary Medical Association 195 , 784788
    [Google Scholar]

More like this

/content/chapter/10.22233/9781910443248.chap12
dcterms_title,dcterms_description
5
5
Loading Operative Techniques...

Loading Operative Techniques...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error