The document discusses normal spleen physiology and various spleen disorders. The spleen is located in the left upper quadrant of the abdomen and serves lymphoid and phagocytic functions. Hypersplenism is associated with pancytopenia and splenomegaly, which can be primary or secondary. Splenomegaly has many potential causes including infections, cancers, and storage disorders. Splenic infarction is usually due to emboli from the heart, while splenic rupture commonly results from trauma and can cause life-threatening bleeding. Splenic atrophy may occur in malabsorption states and diseases like sickle cell anemia.

1. Normal Physiology & Disorders
SPLEEN
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2.  Spleen is an encapsulated organ weighing 100-150g in adult
 Situated in the LUQ of the abdomen, mostly concealed by the lower ribs.
 Serves two functions: it is a lymphoid organ, and it has a great capacity
for phagocytosing particulate material in the circulation.
 The lymphoid function occurs in the white pulp & the phagocytic activity
resides in the red pulp.
NORMAL PHYSIOLOGY:
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3. The term is applied to the association between a peripheral blood
pancytopenia & splenic enlargement.
It may be primary or secondary to a wide variety of pathological processes.
Primary hypersplenism is a poorly understood condition of unknown etiology
1° is characterised by marked & often massive splenomegaly &
pancytopenia.
2° splenomegaly may also be associated with hypersplenism.
HYPERSPLENISM
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4. Many causes, including vascular congestion, inflammatory & reactive
disorders, leukaemias & lymphomas, & storage disorders.
Enlarged spleen may rupture after only minor trauma.
2° splenomegaly may result in hypersplenism.
The causes of 2° splenomegaly include:
• Congestion
• Infection
• Immune disorders
• 1° or metastatic neoplasms
• Storage disorders
• Amyloidosis
SPLENOMEGALY
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5. Splenic infarction follows occlusion of the splenic artery or its branches & is
usually 2° to emboli that arise in the heart.
Occasionally, splenic infarction may be due to local thrombosis, as in sickle
cell disease, myeloproliferative disorders & malignant infiltrates.
SPLENIC INFARCTION
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6. Usually caused by blunt abdominal trauma, particularly automobile accidents.
Massive, life-threatening intraperitoneal haemmorhage may follow rupture,
necessitating emergency splenectomy.
Spontaneous rupture may occur, particularly in infectious mononucleosis & in
spleens enlarged by haemopoietic proliferations such as myelofibrosis.
SPLEEN RUPTURE
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7. May occur in association with intestinal malabsorption states such as coeliac
disease.
Spleen is small & weighs <50g.
Evidence of hyposplenism with numerous target cells & Howell-Jolly
inclusion bodies in red cells.
Patients with sickle cell disease suffer multiple splenic infarcts & the spleen is
greatly reduced in size & function.
SPLENIC ATROPHY
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