Journal of Medical Sciences and Health

Introduction

Spleen consists of a large encapsulated mass of vascular and lymphoid tissue situated in the upper left quadrant between fundus of stomach and diaphragm. It is shape varies from a slightly curved wedge to a domed tetrahedron. The size and weight of the spleen varies with age and sex. It can also vary in the same individual under different conditions. On an average it is 12 cm long 7 cm broad and 4 cm thick in the adult. Weight of the spleen ranges from 80 to 300 g average being 150 g.[1] Spleen assumes clinical importance due to hematological and immunological role. Surgeons also like to conserve splenic tissue during splenectomy due to the same reasons. The present study was undertaken to describe the morphometric variations in spleen and compare it with the available literature which would prove useful to both clinicians and academicians.

Materials and Methods

Results and Discussion

Out of 53 spleen studied 18 (34%) were wedge shaped (Figure 1), 18(34%) were triangular (Figure 2), 5 (9.4%) were oval (Figure 3), 8 (15%) were tetrahedral (Figure 4) 2(3.7%) were heart shaped (Figures 5 and 6), and 2 (3.7%) were semi lunar (Figure 7 and Table 1).

Weight of the spleen ranged from 53 to 444 g (Table 2). Out of the 53 spleen studied 31 spleens were in the weight range of 50-150 g. 13 spleens between 151 and 250 g, 3 spleens between 251 and 350 g, 5 spleens between 351 and 450 g and 1 spleen in the weight range of 451-550 g. Length of the spleen ranged from 50.5 to 144.3 mm average being 96.88. Breadth of the spleen ranged from 43.7 to 107.5 mm average being 68.4.
Thickness of spleen ranged from 22.3 to 52.14 mm average being 36.12.
Notches were only seen on the superior border of the spleen and 44 spleens had single notches.3 spleens showed the presence of multiple notches of 2 or more and in 5 spleens no notches were seen.

Discussion

In the present study, the morphometry of spleen was compared with previous studies. The values for shapes of spleen in two of the spleens studied in each.

Notches were observed only on the superior aspect of spleen. Presence of notches on the superior margin is useful for the physician to palpate the spleen during enlargement of spleen.[6] Previous studies regarding the site of notches on the spleen have revealed the presence of notches on the superior order in 98% Das et al.,[7] 78.6% by Skandalakis et al.,[8] 50% Sateesha et al.[9] Previous studies have shown the presence of notches on both superior and inferior aspects of spleen which was not found in our study.[3] Notched superior border results from improper fusion of the splenic nodules along the superior margin. Computed tomographic based study on the morphometry of spleen showed that all dimensions of spleen have significant positive correlation with height but length of the spleen has negative correlation with age.[10] This correlation could not be studied in this case, as we had measured the dimensions on spleens which had been previously dissected out.
Study of foetal spleen revealed that the ratio between foetal and splenic weight has no correlation with the gestational age.[11]

Conclusion

To conclude, knowledge of the anatomy and function of the spleen is essential for the assessment of its role in disease. The contribution of spleen to the immune response and defence against infections mandates the preservation of spleen by a conservative approach in the management of ruptured spleen. Studies on the morphometry of spleen will be of interest not only from academic point of view but also for operating surgeons and interventional radiologists. The detailed knowledge on spleen is important to avoid and prevent any complications and to obtain a good operative, as well as diagnostic intervention.