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.

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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.

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