Evaluation and Management of Spleen Injuries

Anatomy of the Spleen

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  Location

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    Situated under the left diaphragm at the level of ribs 9–11

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    Important relations

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      Lateral to the stomach

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      Anterosuperior to the left kidney

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      Tail of the pancreas is in proximity to the hilum.

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  Ligaments

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    Four ligaments attach to the spleen.

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      Splenophrenic ligament

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    Connects posterolateral surface of the spleen to the diaphragm

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      Splenorenal ligament

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        Connects posterolateral surface of the spleen to the Gerota fascia of the left kidney

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        Also attached to the splenic hilum, splenic vessels, and tail of the pancreas

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      Gastrosplenic ligament

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        Connects medial surface of the spleen to the greater curvature of the stomach

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        Is the only vascular ligament

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        Contains 5–7 short gastric vessels

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      Splenocolic ligament

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    Connects the inferior pole of the spleen to the splenic flexure of the colon

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  Structures at the hilum

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    Splenic artery

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      Branch of the celiac trunk

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      Runs along the superior surface of the pancreas toward the splenic hilum

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      Divides into upper and lower pole branches at the hilum

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      Branches of the splenic artery

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        Short gastric arteries (5–7)

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        Left gastroepiploic artery

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        Dorsal pancreatic artery

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        Greater pancreatic artery

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      Splenic vein

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        Upper and lower pole veins form the splenic at the hilum.

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        It runs posterior and inferior to the splenic artery.

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        The inferior mesenteric vein drains into the splenic vein.

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        The superior mesenteric vein joins the splenic vein and forms the portal vein posterior to the neck of the pancreas.

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      The tail of the pancreas is closely related to the hilum.