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Aproach to the patient with Splenomegaly :

Aproach to the patient with Splenomegaly :. اعمال طحال 1-Filtration 2-Immunologic 3-Reservoir 4-hematopoietic. Dr.Azarm. Dr.Azarm.

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Aproach to the patient with Splenomegaly :

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  1. Aproach to the patient withSplenomegaly:

  2. اعمال طحال 1-Filtration 2-Immunologic 3-Reservoir 4-hematopoietic Dr.Azarm

  3. Dr.Azarm

  4. The presence of HowellJolly bodies in the peripheral blood indicates that the patient has had a splenectomy or has a process that has rendered the spleen nonfunctional

  5. Dr.Azarm

  6. The white pulp of the spleen contains macrophages, B lymphocytes, and T lymphocytes, participates in the recognition of microorganisms and foreign proteins, and is involved in the primary immune response

  7. Splenic function: • Cellular and humoral immiunity • Removal of senescent red blod cells,bacteria and other particulates from the circulation • One third of circulating platelets are sequestered in the spleen • The spleen may become the site of extramedullary hematopoisis,abnormally

  8. How could we diagnose splenomegaly? • Physical examination(the most important) • X-ray • Nuclear medicine • CT scan • MRI

  9. The splenic red pulp occupies more than half the volume of the spleen and is the site where senescent red cells are identified and destroyed and red blood cell inclusions are removed by a process known as pitting

  10. Anatomical information of the spleen: • It’s in posterior portion of the left upper quadrant of peritoneal cavity. • It’s below the diaphragm and adjacent to the 9th to the 11th ribs,stomach,colon,left kidney and tail of pancreas. • It weighs 80 to 200 gr in males and 70 to 180 gr in females. • It is not usuallypalpable,except in children,adolescents and some adults especially those of asthenic build.

  11. Dr.Azarm

  12. What happens if we remove spleen? • These patients are more susceptible to bacterial sepsis,especially with encapsulated organisms.

  13. What happens if we remove spleen? • Without spleen, different abnormal red cells will be present in blood circulation: • senescent red cells • red cells with nuclear remnants(Howell-jolly bodies) • insoluble globin precipitates(Heinz bodies)

  14. Symptoms of hyposplenism and asplenia: • Sepsis with encapsulated organisms,esp in children • Mild degrees of thrombocytosis and leukocytosis • Howell-jolly bodies in circulating red cells,along with increased number of target cells ans misshapen red cells. • Increased number of erythrocyte and Heinz bodies.

  15. Splenosis: • It is caused by splenic implants which may result from the spillage of cells from the splenic pulp following injury or splenectomy.

  16. Splenosis: • . • It can be located in peritoneal cavity and even in pleural or pericardial cavities. • These are normal splenic tissues and can be diagnosed via tissue biopsy techniques

  17. The spleen is the larg est lymphatic organ in the body and is sometim es approached clinic ally as though it wer e a very large lymph node.

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