Revathi, S (2020) A Cadaveric study of Segmental Branches of Splenic Artery-Anatomy and Its Variations. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION: The human spleen is highly vascular and friable and so it cannot be sutured. It is the largest of the lymphoid organ, which contains 25% of the body’s lymphoid tissue. Spleen is a secondary lymphoid organ as it is the site of maturation of lymphocyte, their activation and initiation of an immune response. Spleen is the organ of haemopoeisis before bone marrow development. The spleen is called as the “Grave yard of Dead Red Blood cells” as the spleen is the site of red blood cell destruction. The spleen has the third highest blood perfusion rate. The spleen is called as melancholy as ancient Greece scientist thought that the spleen was the source of black bile. Historically spleen was considered as a vestigial organ and was surgically removed even for minor ailments and injuries because it was considered that the spleen was not essential for life as removal of spleen does not lead to sudden death. Dimensions and functions of spleen were discovered in the 20th century. After understanding the fact that the spleen is called upon primarily to eliminate senescent and damaged cells from the circulation, to filter the antigens and its role in immunological response, spleen preserving surgeries gathered importance. AIM OF THE STUDY: The present study was carried out to study the terminal branching pattern and the number of terminal branches entering hilum. To study the number of segmental branches, also the occurrence of Superior and Inferior Polar arteries and the origin of Superior and Inferior polar arteries. To study number of Splenic notches by dissection method. MATERIALS AND METHODS: The present study was carried out in 50 specimens obtained from formalin preserved human cadavers of Institute of Anatomy, Madurai Medical College. Each spleen was dissected by a piece meal dissection. OBSERVATION AND RESULTS: Distributed type of branching pattern in 43 specimens and bundled type of branching pattern in 7 specimens. Two terminal branches were found in 42 specimens, three terminal branches were found in 7 specimens, four terminal branches were found in one specimen. Two segmental branches found in 4 specimens, three segmental branches in 16 specimens, four segmental branches in 24 specimens, five segmental branches in 6 specimens. Superior polar artery alone found in 7 specimens, inferior polar artery alone found in 18 specimens, both superior and inferior polar arteries found in 10 specimens, both arteries not found in 15 specimens. The superior polar artery arises from splenic arterial trunk in 14 specimens and in 3 specimens it arises from terminal branches. The inferior polar artery arises from splenic arterial trunk in 23 specimens, from terminal branches in 5 specimens. Only one notch present in 12 specimens, two notches in 32 specimens, three notches in 2 specimens, four notches in 2 specimens, five notches in 1 specimen. In one specimen no notches present. The observations have been recorded, summarized and discussed from the point of view of their surgical application with special reference to the partial splenectomy that are becoming popular in case of splenic injury. The data obtained in the present study was correlated with data of the previous studies. CONCLUSION: The knowledge of these terminal branching pattern and its identification in colour Doppler flow imaging is important while planning for laparoscopic splenectomy. In distributed pattern of splenic pedicle the ligation of splenic artery prior to splenectomy should be done individually whereas in bundled pattern the trunk can be cut off. Ligation of splenic branches should be started from the inferior pole of the spleen as most of the splenic artery branches were very slender and can readily be missed. Presence of notches on the superior margin is useful for the physician to palpate the spleen during enlargement of spleen. So multiple notches may lead to a false positive clinical diagnosis of splenomegaly and when there were multiple notches present in the anterior border, these lobulations may easily be mistaken for neoplasms of the kidney or adrenal gland radiologically. In patients with blunt abdominal trauma to the left hypochondrium, the presence of multiple deep and sharp notches on the spleen may inaccurately be misinterpreted as splenic lacerations, possibly resulting in an unnecessary exploratory laparotomy.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 201733102 |
| Uncontrolled Keywords: | Splenic artery, Terminal Branches, Segmental Branches, Superior Polar Artery, Inferior Polar Artery. |
| Subjects: | MEDICAL > Anatomy |
| Depositing User: | Subramani R |
| Date Deposited: | 06 Feb 2021 03:28 |
| Last Modified: | 06 Feb 2021 03:29 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13911 |
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