Spleen Sx - Karnik
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Created by:
tdschraeder on March 11, 2012
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64 terms
Terms | Definitions |
|---|---|
 What are siderotic plaques? | tan/rust-colored plaques typically on the margin primarily Fe+ & Ca+ normal aging finding NOT a sx problem |
| What is splenosis? | multiple nodules of normal splenic tissue in the abd. cavity purple "grapes" functional tissue NOT sx! |
| T/F Splenosis can be either congenital or traumatic? | T |
| T/F Splenosis indicates non-functional tissue? | F |
| T/F Hyperplastic nodules (splenosis) are a more common finding upon necropsy than HSA? | T |
| Splenic torsion is most common wh/what other problem? | GDV |
| What breeds are most affected by splenic torsion? | Great Dane Grtr Swiss GSD |
| T/F Splenic torsion may be an isolated event? | T |
| What are the c/s associated w/ACUTE splenic torsion? | acute abd. - smilar to GDV CV collapse arrythmias DIC |
| Is acute splenic torsion a sx emergency? | YES! |
| What are the c/s of chronic splenic torsion? | ADR intermittent signs for up to 2 weeks: V/D weakness/depression anemia hematuria/hemoglobinuria icterus |
| What would you expect to see on rads of splenic torsion? | diminished visceral detail assoc. w/peritoneal effusion & displacement of the SI |
| What are the rad. signs of splenic dz? | mid-abd. mass abd. eff. gas bubbles in spleen c-shaped spleen |
| Gas bubbles in the spleen are indicative of _______. | necrosis |
| What is the most diagnostic tool for a splenic torsion? | U/S |
| What would you expect to see upon U/S of a splenic torsion? | mottled or diffuse hypoechoic areas intraluminal echogenic densities in veins no flow in splenic vessels diffusely hypoechoic areas w/linear echoes vascular congestion/compression thrombosis of splenic v. |
| What is the protocol for pre-op stabilization for a pt. w/a splenic torsion? | fluids transfusion abx for clostridium |
| What are the txt options for splenic torsion? | pre-op stabilization splenectomy +/- gastropexy |
| What are 6 other problems associated w/splenic infarction? | renal dz (PLN) hyperadrenocorticism Neoplasia DIC heart dz prior splenic torsion |
| What is nodular hyperplasia? | Sites of extramedullary hematopoiesis. |
| T/F Nodular hyperplasia of the spleen is a natural aging change | T |
| Why is nodular hyperplasia of the spleen a diagnostic dilemma? | It could be neoplasia or benign. An FNA is not diagnostic & you could cause bleeding if you poke it w/a needle or you could rupture it & cause a hemoabd. |
| What are your txt options regarding splenic trauma? | conservative mgmt partial splenectomy complete splenectomy autotransplantation??? |
| What is considered conservative mgmt. w/regard to splenic trauma? | watch serial PCV's & try to ctrl bleeding w/a belly wrap. |
| T/F Most splenic trauma cases are an emergency sx case? | F (most can be conservatively managed) |
| When would you perform autotransplantation of the spleen what is an important part of autotransplantation? | Perform when most of the spleen is normal. Leave part of the spleen in the omentum & see if it resumes normal function. |
| T/F if an animal w/splenic trauma has normal coagulation parameters, most will stop bleeding on their own? | T |
| What is an important factor to remember regarding administration of colloids to a pt. w/splenic trauma? | Don't give fluids too rapidly b/c colloids can increase bleeding. |
| How do you manage a pt. w/a hemoabdomen? | poss. transfusion purified hemoglobin proxygenate EKG correct dehydration, electrolyte & acid-base abn. monitor hematocrit periop. abx may be necessary |
| Why would you need to monitor the PCV/hematocrit in a pt. w/splenic trauma? | B/c the fluids you are giving them can decrease their PCV. |
| What are the 5 types of Splenic Neoplasia? | Hemangioma HSA Lymphosarcoma (m.c) Sarcomas Mast Cell Tumor (cats) |
| What are the possible sarcomas observed in dogs? | fibrosarc. leiomyosarc. osteosarc. hemangiosarc. |
| What is the prognosis for a mast cell tumor in the spleen of the cat vs. the instestine? | spleen - guarded intestine - poor |
| What is the 2/3 law of splenomegaly in dogs? | 2/3 w/splenomegaly have neoplasia 2/3 of those have HSA |
| What breeds are at increased risk of HSA? | GSD & Goldens |
| What are the chances of a splenic mass being either malignant or benign? | 50/50 |
| Of the 50% of splenic masses th/are malignan, what % of those are HSA's? | 50% |
| If an animal has a splenic mass & hemoabd., what are the chances that it is a HSA or a benign lesion? | 75% chance of it being a HSA & 25% chance of it being a benign lesion. |
| What are the common primary sites for HSA? | spleen Rt. atria SQ tissue liver |
| Why have most HSA's already met. prior to dx? | b/c the tumor cells are constantly being filtered through the spleen. |
| In the case of HSA's, if mets haven't been detected, ______ decreases the risk of a major intra-abd. bleed. | splenectomy |
| What % of pts w/HSA have a concurrent rt. atrial mass that is observed via echo? | 10% |
| What is the prog. for a HSA w/sx alone? | 2-4 mos. |
| What is the prog. for HSA w/ sx + chemo? | ~7 mos. |
| What is the primary blood supply to the spleen & what is it's parent a.? | splenic A &V parent A. is the celiac A. |
| T/F Arrythmias associated w/splenectomy are typically atrial. | F (ventricular!) |
| What type of arrythmia may be present pre-opreatively & is common PO removal of the spleen? | ventricular |
| Pts th/undergo a splenectomy commonly have a ______ ______ postoperatively. | splenic rupture |
| What are the indications for a partial splenectomy? | trauma focal abscess partial infarction masses??? |
| What is the primary goal of a partial splenectomy? | preserve function |
| What are the indications for a total splenectomy? | neoplasia torsion severe trauma |
| What are 2 important procedures to perform when performing a total splenectomy? | double ligate vessels at the hilus preserves branches to the pancreas & stomach |
| T/F A total splenectomy takes less time than partial splenectomy? | T |
| What is the txt of choice in dogs w/ acute splenic torsion? | total splenectomy |
| What is the ONLY viable option for chronic splenic torsion? | total splenectomy |
| What are 2 medical cond's th/will predispose the spleen to infarction? | PLE hyperadrenocorticism |
| What are the 3 sx stapling techniques? | hemoclips surgiclips ligate divide stapler (LDS) |
| What are the potential complications following splenectomy? | hemorrhage pancreatits/necrosis gastric wall compromise subclinical hemoparasite infections sepsis |
| What is one possible justification for prophylactic abx w/future sx's w/regard to the spleen? | sepsis |
| What are the primary branches of the celiac a? | short gastric a.a. & v.v. lt. gastroepiploic a & v & splenic a & v |
| The lt. gastroepiploic a & v & splenic a & v. combine to form the _______ _______ a & v. | short gastric |
| Transection of the _______ ligament & _______ _______ vessels will predispose the pt. to _______. | gastrosplenic short gastric GDV |
| T/F Lt. gastroepiploic vessels can be transected w/o causing a problem when performing a total splenectomy. | T |
| If you ligate the ______ vessels too close to the stomach, you will get _______. | gastric pancreatitis. |
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