scholarly journals A Cadaveric Study on Morphometric Features of Spleen and Splenomegaly with Accessory Spleen in Hilum

2021 ◽  
Vol 9 (4) ◽  
pp. 8181-8184
Author(s):  
Khaleel N ◽  
◽  
Abinet GM ◽  
Angadi A V ◽  
Muralidhar P S ◽  
...  

Background: Anatomical knowledge regarding the external morphology of the spleen is essential for surgical intervention and radiological diagnosis. Splenomegaly is defined as pathologic enlargement of the spleen measured by size or weight. A normal spleen has a craniocaudal length of no more than 12 cm and weighs less than 200 g. It is surrounded by a thin capsule. The spleen is usually not palpable unless it is enlarged; therefore, a palpable spleen is almost always abnormal. At times the spleen may be difficult to palpate, but dullness to percussion during inspiration in the area of the lower left intercostal space in the left anterior axillary line suggests splenic enlargement. Massive splenomegaly, weight >1000 g usually occurs in lymphoma, myeloproliferative disorders, visceral leishmaniasis, and malaria. Materials and Methods: This study was conducted in different medical institutions, to find morphometric features, spenomegaly in cadaver during routine anatomy dissection as part of curriculum, 100 cadavers were observed to find out splenomegaly. Results: Out of 100 spleens studied, 81 cases wedge shaped spleen was the most common, followed by 12 tetrahedral shaped spleens and 7 oval shaped spleens. Average weight of the spleen was 175g. Average length of the spleen was 11.64cm, Average breadth of the spleen was 7.3cm and average thickness of spleen was 3.6cm. Out of 100 cadavers observed only one cadaver observed with massive splenomegaly with one accessory spleen in hilum. The spleen weight was 875gm, length was 18.15 cm, width was 8.65cm, thickness was 5.75cm and extended upto 7 rib and it is easily palpable below the rib cage from lumbar aspect. The cadaver was male and age around 55 years. Conclusion: The morphometric knowledge of spleen will helpful for surgeons and for understanding deceases related spleen. The knowledge of splenomegaly is important in finding splenic disorders and accessory spleen information helpful in understanding embryonic development of spleen. KEY WORDS: Splenomegaly, Spleen, Hilum of Spleen, Accessory spleen.

2020 ◽  
Vol 6 (1) ◽  
pp. 10-14
Author(s):  
D. Srivani ◽  
P. Sofia ◽  
J. Jayachandra Pillai

Introduction:The spleen is the largest hemolymphatic organ of the human body that plays a significant role in Hematopoiesis and immune phagocytosis. Recent studies have emphasized the importance of spleen as hematopoietic organ in fetal period, role in synthesis of immunoglobulins & defense of human body against infections. A thorough knowledge of splenic morphometry and dimensions is vital in comprehending the development of spleen in fetal period.Aim:The aim of the study is to study detailed morphometric analysis  human fetal splenic specimens of various gestational ages  and compare the findings with earlier studiesSubjects and Methods:The  present  study  included  40  fetal cadaveric spleen and  morphometric features i.e.,length, breadth, width and weight of spleen were measured.Results:The average weight of the fetal spleen was 1.98 gm and varied from 0.1 to 5.1 gm. The average length, breadth and width of spleen in prenatal group were 2.21 cm, 1.39 cm and 0.645 cm respectively. In the present study the average weight of the fetal spleen was 1.98 gm and varied from 0.1 to 5.1 gm. There was statistically significant increase in splenic weight till 33 weeks.Conclusion:Knowledge of spleen size at different gestational ages will help in early detection and diagnosis of splenic anomalies, identifying congenital malformations, early diagnosis and prompt treatment of intrauterine infections.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guiqin Chen ◽  
Lei Nie ◽  
Tijiang Zhang

Abstract Background The accessory spleen has no anatomical or vascular relationship with the normal spleen, The tissue structure and physiological function of the accessory spleen are the same as those of the normal spleen, which usually locate in the splenic hilum and the tail of the pancreas. The aims of this manuscript are to present a rare case of the gastric accessory spleen and a review of the literature. Case presentation A 19-year-old male patient was sent to the emergency department with stomach bleeding after drinking alcohol. The computed tomographic scan showed a 1.2 cm × 1.7 cm mass at the lesser curvature of the gastric fundus. Gastrointestinal endoscopy displayed a submucosal elevated lesion on the gastric fundus, and gastrectomy was performed. Postoperative pathological examination proved an accessory spleen in the stomach. The postoperative course was uneventful, and the patient was discharged on the 6th day after the surgery. Conclusions The accessory spleen at the fundus of stomach is extremely rare, especially in this case, which is accompanied by acute gastric bleeding, and it is difficult to diagnosis before operation. Many literatures reported that it was misdiagnosis as tumor, so it is necessary to diagnose accessory spleen correctly.


Author(s):  
Rajesh Kumar Sinha ◽  
Asha Kiran ◽  
Vivek Kashyap ◽  
Praveen Kumar

Background: Children with severe acute malnutrition (SAM) having medical complications require immediate care at malnutrition treatment centers (MTC). Thus, it becomes important to assess the effect and treatment cost of such children in these facilities. Hence, the present study was done with these aims in two MTCs in Jharkhand, India.Methods: A retrospective record review was done of the children admitted to these two MTCs between 1st April 2017 and 31st March 2018. A predesigned proforma was used to collect child related information. The data collected was entered in Microsoft excel sheet and analysed.Results: Majority of the admitted children (90.6%) were in 6-23 months age group. 358 (51.5%) children were females. Only, 194 (27.9%) children admitted were SAM had any medical complication. 690 (99.3%) children were discharged of whom 499 (72.3%) were discharged after achieving the target weight. The average weight gain during their stay was 8.1±2.4 g/kg/day and average length of stay was 16.7±3.2 days. Post discharge follow up rates were found to be low and only 130 (18.8%) children completed all three follow ups. Average cost per SAM child treated was Rs. 18,599 (US$ 272) and per SAM child cured was Rs. 25,904 (US$ 379).Conclusions: MTCs are effective in managing medically complicated SAM children. However, improvements are necessary to ensure that more such children should be treated at facility level, complimented with a community based programme for managing uncomplicated SAM children to improve coverage and ensure continuum of care.


2003 ◽  
Vol 33 (4) ◽  
pp. 719-722 ◽  
Author(s):  
Sérgio Fonsêca Guimarães ◽  
Atílio Storti Filho

Matrinxã is a very promising amazonian fish for fish culture in Brazil. This study is aimed at determining the approximate tolerated temperature range in this species. Groups of ten young matrinxã specimens (15.1±0.8 cm average length and 58.3±10.3 g average weight) were subjected to 9 different temperatures for 24 hours without previous acclimation. Fish were transferred from an initial temperature of 27ºC to those ranging from 12 to 39ºC at 3ºC intervals. Both 12ºC and 39ºC temperatures were lethal for this species with 100% mortality rate. Following 2 minutes of exposure to 39ºC fish changed behavior, showing an increase in opercular movements and erratic swimming; mortality reached 100% after 18 minutes. At 12ºC, fish lost equilibrium immediately after exposure and started swimming erratically; after only 4 minutes fish became lethargic and remained immobile on the bottom of the tank. Total mortality was only evident following 24 hours. At 15ºC matrinxã lost equilibrium after 5 to 6 minutes of exposure but mortality was only 20% after 24 hours. Fish tolerated well temperatures ranging from 18 to 36ºC with 100% survival after 24 hours. This preliminary study suggests that temperatures between 18 and 36ºC are the approximate range normally tolerated by this species, although survival at other temperatures may be increased by gradually acclimating fish to the more severe increases or decreases in temperature. In addition, it indicates that matrinxã may be cultivated over a wide geographical area.


2020 ◽  
Vol 6 (6) ◽  
pp. 678-687
Author(s):  
Godofredo Román Lobato Calderón ◽  
Pascual Guevara Yanqui ◽  
Miguel Ángel Ramírez Arellano

In the present investigation, the weight, growth, adaptability and production of humus of a calf foot of Californian red worm (Eisenia foetida) fed with compost (made from animal excreta and organic waste) and organic remains were evaluated. The evaluation was carried out in Tarma, Junín Region. A breeding ground was built with 3.2 m3 cement bricks (6.10 m long  1.05 m wide and 0.50 m high); with a 5 cm thick screed with a 2” PVC drain pipe with a west-east slope, raised by the west side at 15°. A population of 10,000 individuals (10 kilograms) was sown, a sample of 370 individuals was extracted by applying a Simple Random Sampling (MAS) whose average weight and length was 0.3 g and 30 mm. they were fed for 3 months (90 days), the calf was divided into 21 sampling points from which 383 worms were weighed and measured whose average weight and length were 0.38 g and 33.24 mm (3.32 cm). Data were taken every day at 2:00 pm, hydrogen potential (pH) and humidity (soil peach meter), substrate temperature (digital thermometer), ambient temperature (thermohygrometer) were recorded. The average weight of the worms varied from 0.30-0.38 g, the average length varied from 30-33.24 mm. The presence of tiny heels and worms demonstrated their adaptability. The production of humus was 3 tons, the efficiency of the breeding stock was 93.75%. The final substrate had an average of 6.72 pH, 13.61°C temperature, 69.86% humidity and 19.5°C ambient temperature. Consequently, vermicompost is an alternative in the treatment of organic solid waste to be developed in high Andean areas.


2018 ◽  
Vol 4 (4) ◽  
pp. 406-415
Author(s):  
Md Reazul Islam ◽  
Rashida Khaton ◽  
Md Aktharul Alam ◽  
Md Jalal Uddin Sarder ◽  
Md Najmul Hassan Parvez

The purpose of this study was to comparative histomorphological investigation of the non affected and affected bile duct and gall bladder by fascioliasis in Black Bengal goat. The average weight of affected gall bladder was 26.10±0.70 gm which was significantly (p<0.001) higher than non affected gall bladder (19.40±0.96 gm). The average length and girth of affected gall bladder were 10.30±0.37 cm and 8.24±0.30 cm, respectively which were also significantly (p<0.001) higher than the length (6.10±0.30 cm) and Girth (5.85±0.25 cm) of non-affected gall bladder of Black Bengal Goat. The gross changes in acute form, thickening of the bile ducts and fibrosis in a portal area due to chronic fascioliasis was found in case of affected bile duct but were not found in case of non affected liver. A brownish exudates and a number of mature Fasciola gigantica were found in the lumen. The adult Fasciola gigantica was noticed in cross section in the lumen of the thickened bile ducts. Acute pathological lesions could only be produced by developing flukes prior to their entry to the bile ducts. Microscopically the epithelial layer of the bile ducts were seen to the partially disintegrated, but simultaneous proliferation of epithelial cells occurred. Thickening of the bile ducts was the result of connective tissue proliferation. Deposition of bile pigment in the tissue space and bile duct in some parts showed periductal cellular infiltrations, mainly neutrophiles, lymphocyte and eosinophiles. No calcification in the wall of the bile ducts in chronic Fascioliasis in goat could be seen in this study. The gall bladder was very dark usually contained blood clots, the consistency of bile was also very dense. Microcopically hyperplasia of the tubuloalveolar glands and numerous eggs were seen in the bile of infected goat which were absence in case of non infected goat. Asian J. Med. Biol. Res. December 2018, 4(4): 406-415


2019 ◽  
Vol 48 (2) ◽  
pp. 030006051987589
Author(s):  
Youjian Li ◽  
Xuefeng Qiu ◽  
Weijian Li ◽  
Hongqian Guo ◽  
Xiaogong Li

An accessory spleen refers to single or multiple splenic tissues that appear outside the normal spleen position and have structures and functions similar to those of a normal spleen. We herein present a rare case of a 31-year-old woman who was hospitalized because of a 14-year history of sudden left upper abdominal pain after running. Abdominal computed tomography suggested a large soft tissue mass at the left renal hilum surrounded by several enlarged lymph nodes, which was totally different from computed tomography scanning of normal accessory spleen. The mass was resected by robot-assisted laparoscopic surgery. Histopathological examination confirmed the diagnosis of accessory spleen. The incidence of retroperitoneal accessory spleen is very rare, which should be differentiated with retroperitoneal tumors.


1969 ◽  
Vol 73 (2) ◽  
pp. 109-114
Author(s):  
Megh R. Goyal ◽  
Rubén Guadalupe-Luna ◽  
Evangelina R. De Hernández ◽  
Carmela Chao de Báez

Sweet peppers (var. Cubanelle) graded for width, length and weight were evaluated after three fertigation treatments (T1 = 150, T2 = 300 and T3 = 500 Kg of N/ha), 500 Kg of N/ha side-dressed (T4), no fertilizer (T5), plastic mulching (P) and no mulching (NP). Nitrogen source was urea. The relationships of average width and average weight versus days after transplanting were sigmoidal. A linear relationship was found between average length versus days after transplanting. More than 50% of peppers were within size classes 1 to 4 ; fewer than 40% were in the size classes 5 to 9. During the growing cycle, mean numbers of peppers and weight per pepper in each size class were not statistically different (P = 0.05) among main treatments (T1, T2, T3, T4, T5). In size classes 1 to 9, there were significantly more peppers (P = 0.05) in P plots than in NP plots. Fruit parameter values decreased with successive picking and were significantly lower (P = 0.05) in the 5th picking and were higher in the P plots than in the NP plots (P = 0.05). Fertilization and fertigation resulted in higher values than non-fertilization.


Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2848-2848 ◽  
Author(s):  
Preet Paul Singh ◽  
Taner Timucin ◽  
David M Nagorney ◽  
Ayalew Tefferi

Abstract Abstract 2848 Background: Massive splenomegaly (MS) (>1500 grams) is a rare and overtly symptomatic manifestation of myelofibrosis. While splenectomy may provide palliation, the procedure may be technically difficult and lead to high operative risks. We retrospectively analyzed myelofibrosis patients who underwent splenectomy for MS to analyze complications and outcomes. Methods: Retrospective chart review of all patients with myelofibrosis at our institution who underwent splenectomy for MS between 1998 and 2006 was performed. MS was defined as post-operative spleen weight measured to be more than 1500 grams. A total of 63 patients with MS had splenectomy for palliation of pressure symptoms or transfusion requiring cytopenias during that time period. Kaplan Meier statistics and log rank test were used for survival analysis. Results: Mean age of the study patients was 64.9 ± 9.5 years and 56% of those were males. Commonest pre-splenectomy symptoms were left upper quadrant abdominal discomfort (85.7%), fatigue (81%), early satiety (76.2%), anorexia (54%) and weight loss (39.7%). Packed red blood cell and platelet transfusions were required pre-operatively in 36/63 (57.1%) and 10/63 (15.9%) of patients, respectively. Median spleen weight was 2805 (range 1540 – 13085) grams. Perioperative complications occurred in 15 patients (23.8%) including infection (= 4 patients [6.3 %]), thrombosis (= 6 patients [9.5%]), or bleeding (= 9 patients [14.3%]), 2 of which (3.2% of all patients) were fatal. Median post-splenectomy survival (PSS) of these patients was 16.4 (0–110) months and 5 year PSS was 20%. Excluding patients lost to follow up, 43/55 (78.2%), 33/55 (60%) and 26/54 (48.1%) patients were alive at 6 months, 1 year and 2 years after splenectomy, respectively. At 1 year, out of 33 alive patients, 24 (72.7%) patients had relief of pressure symptoms. Out of 36 patients who were red cell transfusion dependent pre-splenectomy, 13 were alive and 6/13 (46.2%) patients were transfusion independent at 1 year. Similarly, out for 10 patients requiring platelet transfusions pre-operatively, 5 were alive and 3/5 (60%) were transfusion independent after 1 year follow up. PSS after splenectomy for MS was decreased in patients that required pre-operative packed red cell transfusions (median 9.3 months vs. 32.1 months, p= 0.033) (Fig 1), but not affected by other factors including age (>64 years), pre-operative thrombocytopenia (<100 × 109/uL), prolonged operative time (>90 minutes) or larger spleen size (>2800 grams). Conclusions: Splenectomy is relatively safe and effective palliative treatment for pressure related symptoms and refractory cytopenias related to MS in patients with myelofibrosis. Pre-operative anemia requiring red cell transfusions may predict advanced disease and is associated with inferior PSS. Disclosures: No relevant conflicts of interest to declare.


Folia Medica ◽  
2011 ◽  
Vol 53 (4) ◽  
pp. 34-41 ◽  
Author(s):  
Hristo Shipkov ◽  
Ali Mojallal ◽  
Fabienne Braye

ABSTRACT AIM: To present and evaluate the outcomes of the posterosuperior pedicle breast reduction technique. PATIENTS AND METHODS: 200 patients were included in the present retrospective study. They were operated on between January 2006 and January 2009. The mean age was 35.9 years (range 22 to 58 years). The average notch-to-nipple distance was 35.8 cm (range, 29 to 42 cm). The mean body mass index was 27 (range, 22 to 35 cm). Results were assessed by means of self-evaluation and by an independent 5-member jury. Fifty two patients (26%) had had bariatric surgery and 48 (24%) had had abdominoplasty. None of the patients had any previous breast surgery. All patients reported dorsal and cervical pain. RESULTS: The mean follow-up period was 16 months (range, 13 to 23 months). The average weight resected was 981 g (range from 370 g to 1800 g). The average duration of surgery was 2h (range, 1.50 to 2.30 hours) and average length of hospital stay was 2.3 days (range, 2 to 4 days). The duration of the outpatient postoperative care until complete wound healing was 15.2 days (range, 13 to 20 days). There were 4 major complications (2%) (1 bilateral and 3 unilateral infections) treated by drainage and intravenous antibiotics. Twenty-two minor complications were recorded (11%) including one desquamation of the nipple-areola complex without necrosis (0.5%) delayed healing at the junction site of the inverted T incision in 21 cases (10.5%). One hundred and forty eight patients evaluated their results as “very good” (74%), 36 as “good” (18%), and 16 as “acceptable” (8%). There were no results assessed as “poor.” Fifty-eight percent of the patients found that back pain had totally resolved versus 42% who had signifi cant improvement though not complete resolution. CONCLUSIONS: The postero-superior pedicle for breast reduction is a reproducible and versatile technique. The preservation of the anterior intercostal artery perforators enhances the reliability of the vascular supply to the superior pedicle.


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