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Purpose. To demonstrate capabilities and features in spleen pathology diagnostics based on clinical experience of Botkin City Hospital.Materials and methods. The analysis of 89 patients with spleen abnormalities was performed in the term from 01/2014 till 08/2020. All the patients underwent computed tomography (CT) and/or magnetic resonance imaging (MRI) with contrast enhancing. All cases verified surgically and/or clinically.Results. There were 37 cases of trauma (42%). Accuracy and precision of the method was 100%. In detection of active bleeding the highest diagnostic accuracy (100%) was shown with extravasation symptom – 7 cases. In non-traumatic group (n = 52, 58%) two biggest sub-groups were abscesses (n = 19, 36% in this group) and infarctions (n = 15, 29%). There were 8 cases of cysts (15%), 3 of them – hydatid, 5 cases of spleen hemangiomas. (9.6%), 3 cases of spleen metastases (6%). There was 1 case of angiosarcoma (2%) and 1 case cystic lymphangioma (2%).Conclusion. The most frequent condition in spleen pathology, diagnosed in radiology department is trauma. In non-traumatic cases two biggest groups are abscesses and infarctions. CT features of spleen infarction are pyramidal wedge of hypoperfused splenic tissue with the apex pointing towards the hilum, and the base on the splenic capsule. In all cases in our study cysts were incidental findings. Spleen metastases are rare due to organ hemodynamics. The most rare lesions of the spleen are primal tumors.

Highlights • Mature teratoma, also called a dermoid cyst. • Dermoid cysts have been observed in various anatomical positions. • Mature cystic teratoma with splenic location. • Splenic dermoid tumors., Introduction Teratomas are germ cell neoplasms that can be malignant or benign. Their occurrence is more prevalent in gonads, but there are rare extragonal reports, and splenic teratomas are exceptionally uncommon. Case report A 44-year-old woman with a report of abdominal pain on the left flank for 12 h, was evaluated with TC that visualized spleen showing an oval, intraparenchymal, hypodense image with dense areas, submitted to conventional splenectomy, what identified mature cystic teratoma. Discussion Dermoid cysts have nonspecific symptoms, usually related to extrinsic compression of other structures or rupture of the splenic capsule; the diagnosis is complex, since the alterations in imaging exams are not very specific. Thus, the confirmation is made through anatomopathological analysis. Conclusion Mature splenic cystic teratomas are rare and treatment should be evaluated according to the presence or absence of symptoms and diagnostic certainty.

Toxoplasma gondii infection induces parasite infiltration and apoptosis in the spleen. However, dose-dependent parasite infiltration, apoptosis, body weight alternations and survival in mice remain largely unknown. In this study, mice were intraperitoneally infected with 10, 30 or 100 tachyzoites of T. gondii, respectively. Parasite infiltration and apoptosis in the spleen were analyzed on days 3, 7, and 9 post-infection by immunohistochemistry and flow cytometry. Significantly higher levels of T. gondii infiltration and apoptosis in the spleen were found in 30 and 100 tachyzoites infected mice compared to 10 tachyzoites infected mice on days 7 and 9 post-infection. Although 30 and 100 tachyzoites infected mice showed significant body weight loss compared to 10 tachyzoites infected mice, all of the 100, 30, and 10 tachyzoites infected mice died by days 12, 15, and 17, each respectively. Interestingly, T. gondii infiltration in 10 tachyzoites infected mice were limited to capsule area of the spleen on day 9 post-infection. Several areas of parasite infiltrations were found in the 30 tachyzoites infected mice, where noticeable levels of splenic capsule de-adhesion occurred. These results indicated that parasite infiltration and apoptosis in the spleen, as well as body weight loss (survival) are closely correlated with infection dosage. The level of T. gondii infiltration and apoptosis in the spleen and splenic de-adhesion were dependent on the parasite dose.

We report findings from an autopsy case who died from massive bleeding because of splenic peliosis. The case subject was an 80-year-old man who had diabetes mellitus and who was receiving hemodialysis and anticoagulant therapy. Postmortem computed tomography demonstrated massive intra-abdominal hemorrhage especially seen around the spleen. At autopsy, we found abundant hemorrhagic ascites, including a large number of clots, in the abdominal cavity. The spleen had several distinct dark red areas ranging in size from 1.5 to 2.5 cm and showed spontaneous rupture along with hematoma formation on the outside of the splenic capsule on the anterior side. From these findings, we concluded that the cause of death in this case was massive hemorrhage owing to spontaneous rupture of splenic peliosis. Although peliosis itself rarely causes death, but when it is destroyed, massive bleeding leads to death. Thus, it is necessary to know the histopathological characteristics of peliosis, in forensics.

The spleen is the largest secondary lymphoid organ with major roles in the removal of blood-borne antigens. The Eurasian moorhen is a wild aquatic bird that revealed the adaptation to harsh environmental conditions. Information regarding the structural features of moorhen's spleen is lacking. The present study aimed to describe the composition of moorhen's spleen using anatomical dissection, histology, histochemistry, immunohistochemistry, and transmission electron microscopy. The spleen appeared as a brownish red sickle-shaped organ close to the proventriculus and gizzard. The splenic capsule was very thin, and the trabeculae were poorly developed. The white pulp formed of the periarteriolar lymphoid sheath, lymphoid follicles, and periellipsoidal lymphatic sheath. The red pulp composed of sinusoids and cords and contained various types of blood cells. Blood vessels were observed within the splenic capsule and inside the parenchyma. Notably, penicillar capillaries (PCs) appeared branched and surrounded by well-developed ellipsoids. Direct connections were observed between PCs and splenic sinusoids suggesting a closed type of circulation. Ultrastructurally, intercellular spaces and vascular channels were evident in the wall of PCs. Ellipsoid-associated cells, lymphocytes, monocytes, and heterophils were observed within splenic ellipsoids. Ellipsoids were thus suggested as a crucial component of moorhen's spleen. Numerous MafB-immunoreactive (IR) macrophages were seen within the red pulp. Splenic cords contained the highest number of PHH3-IR cells, while CCASP3-IR cells were exclusive to follicles of the white pulp. In conclusion, the structure of moorhen's spleen revealed species-specific features. The findings of the present study could help to improve the immunity of domestic birds.

Splenic cysts are rare. Most true (congenital) splenic cysts are epithelial in origin and have embryonic inclusion of epithelial cells from adjacent structures. Congenital spleen cysts are also called epidermoid or epithelial cysts. They form when there is an invagination of the mesothelium-lined splenic capsule during development. The lining is pluripotential and may undergo metaplastic changes and fluid accumulation with resultant cyst expansion. We present our own clinical case of the true spleen cysts in twins. Both patients did’t have any complains. In one of the twins, the lesion was up to 85.0 mm in diameter, localized in the spleen gates and squeezed the spleen vascular pedicle, which necessitated the surgical treatment. In the second twin, the cyst also localized in the spleen gates, however, it was of minor dimensions and, there was no growth at dynamic monitoring at the present time.

Objective: To describe the findings of an unusual splenic tumor in a kitten. Methods: A grossly multinodular mass arising from the splenic capsule of a 7-month-old male Havana kitten was echographically detected and surgically removed by splenectomy, then analyzed microscopically and ultrastructurally. Results: The mass showed features of an inflammatory myofibroblastic tumor. Treatment and Outcome: Two months after surgical excision, the mass recurred in the same intra-abdominal area but disappeared after 2 months of anti-inflammatory therapy. Follow-up at 18 months after surgery revealed resolution of the disease. Clinical Relevance: Inflammatory myofibroblastic tumor in cats have been rarely reported and are usually in the orbital region. In the present report, an unusual multinodular gross presentation, a recurrence over time, and a favorable clinical course, are described.

A 50-year-old man was diagnosed with multiple myeloma complicating AL amyloidosis. Splenic rupture was complicated during autologous stem cell transplantation (auto-SCT). Granulocyte colony-stimulating factor (G-CSF) was not administered. A pathological examination of the spleen revealed that CD34-positive cells were concentrated in the ruptured part of the splenic capsule. Hematopoietic cells were engrafted in the small gap between the capsule and amyloid protein deposition area of the spleen, which might have caused the splenic rupture in the absence of G-CSF administration. Special attention is thus required for amyloidosis patients undergoing auto-SCT, even when G-CSF is not administered.

Background Research describing the splenic capsule and its effect on non-operative management of splenic injuries is limited. The aim of this study is to identify the current beliefs about the splenic capsule thickness and investigate changes in the splenic capsule with age. Methods Trauma Medical Directors were surveyed on their beliefs regarding splenic capsule thickness changes with age. Thicknesses of cadaveric splenic capsule samples were measured. Results The majority of trauma medical directors (59%) believe the capsule thickness decreases with age. There were 94 splenic specimens obtained. The splenic capsules of infants were thin and had a uniform layer of elastin fibers. With aging, the capsule becomes thick and develops a collagen layer. Conclusion Most trauma directors believe the splenic capsule thickness decreases with age. However, our results demonstrate that the splenic capsule thickness increases during childhood but remains constant in adulthood.

Background.Primary splenic angiosarcoma is a very rare mesenchymal malignant tumor associated with a poor prognosis due to its high metastatic potential. This disease can be easily neglected and spontaneous splenic rupture is a frequent manifestation at the time of diagnosis leading to a poor outcome because of peritoneal dissemination.Case Presentation.We describe the case of a 49-year-old man who presented with asthenia, left upper quadrant abdominal pain, and anemia. Computerized tomography scan showed an enlarged spleen with no nodules and a nontraumatic rupture of the splenic capsule. Splenectomy was performed on account of the severe anemia and histopathology examination showed a primary angiosarcoma.Conclusions.Splenic angiosarcoma should be considered as one of the differential diagnoses in patients with nontraumatic spleen rupture and a specific previous medical history. Regrettably, splenectomy allows for a definitive diagnosis but not a curative treatment.

A total number of eighteen day old Hansli chicks and eighteen day old Vencobb broiler chicks were divided into three age groups viz. group I (up to 1 month), group II (1-3 months) and group III (3-6 months) with six birds in each age group. On each observation day (4th week, 12th week and 24th week), six birds from each breed were used for the study of histochemical features of the thymus, spleen and bursa of Fabricius. It was found that the capsule, septa and tunics of blood vessels revealed age specific PAS activities, whereas the Alcian blue activities varied with age and was restricted to the thymic capsule and trabeculae. The splenic capsule, tunics of blood vessels and intercellular region of splenic white pulp revealed age specific PAS positive activity, whereas the Alcian blue activity was only reported in the splenic capsule of 12th week age Hansli chicken and Vencobb broiler chicken. The apical borders of both follicle associated epithelium and interfollicular epithelium, sub-epithelial region, cortico-medullary junction, medulla of lymphoid follicle, interfollicular connective tissue, central connective tissue core of bursal plicae, walls of blood vessels, tunica muscularis and tunica serosa revealed age specific PAS activities, whereas the apical borders of follicle associated epithelium (FAE), interfollicular epithelium (IFE) and goblet cells of lining surface epithelium, tunica muscularis and tunica serosa showed age specific Alcian blue activities in both the birds.

Context: The spleen is the largest single mass of lymphoid tissue in all vertebrates. Histological changes are evident in advancing age along with functional capability of the human spleen. A cross-sectional, descriptive type of study was done in the Department of Anatomy, Dhaka Medical College, Dhaka, from January to December 2008, to see the age related microscopic changes in the human spleen. Methods: 30 human spleens were collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine of Dhaka Medical College, Dhaka. The samples were divided into three age-groups including group A (15-29 years), group B (30-49 years) & group C (50-69 years). Then 5 best prepared histological slides from each group were taken and examined under the light compound microscope to determine the thickness of capsule, diameter, number and percent amount of white pulp in the human spleen. Results: The thickness of the splenic capsule were found 84.60±7.97 ?m, 117.92±4.16 ?m, and 132.17±6.37 ?m in group A, B and C respectively. The diameter of the white pulp were found 0.32±0.01 mm, 0.32±0.01 mm and 0.31±0.01 mm, while the number of white pulp per sq. mm were 2.28±1.04, 2.38±0.93 and 2.04±0.76 in group A, B and C respectively. Moreover, the amounts of the white pulp were determined 23.09±1.38, 24.45±1.84 and 22.54±1.08 in group A, B and C respectively. The difference in thickness of the splenic capsule was statistically significant among the study groups (p

Background: The spleen is the largest single mass of lymphoid tissue in all vertebrates. It is presumed that the architectural design of spleen of domestic and wild animal is different from man. Exact knowledge of histological structure of human, cow and goat can be helpful to differentiate among different species in vertebrates. Methods: A descriptive type of study was carried out in the department of Anatomy, Dhaka Medical College, Dhaka, from January to December 2008. Thirty human spleens were collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine of Dhaka Medical College, Dhaka. Spleens from cow and goat were collected from a slaughter house of Dhaka city. A total of 15 relatively fresh human samples, six from cows and six from goats were selected for histological study. Results: The mean thickness of the splenic capsule was 111.56±21.45 ?m in human, 196.88±11.91 ?m in cow and 251.44±12.56 ?m in goat. The difference in thickness of the splenic capsule was statistically significant among the human, cow and goat (p

A histomorphological study was performed in the major lymphoid tissues (thymus, bursa of Fabricus and spleen) of the six 21-day-old indigenous ducklings of Bangladesh by H & E staining method during the period from March to May 2011. In the present study, it was observed that the thymus was enclosed by a thin connective tissue capsule. Numerous fine septa of connective tissue originated from the capsule and divided the organ into incompletely separated lobules. Each lobule organized into a peripheral cortex and a central medulla. The bursa of Fabricus was consisted of mucosal folds (plicae). Numerous follicles filled the lamina propria of each fold and each bursal follicle was composed a peripheral cortex and a central medulla. A layer of undifferentiated epithelial cells occupied the periphery of the medulla, which was separated from the cortex by a capillary layer. The darkly stained cortex was composed of many closely packed small lymphocytes. The paler medulla contained fewer cells of various sizes. The spleen was surrounded by a thick splenic capsule and there were a small number of trabeculae. The white pulp was composed of network of reticular cells and reticular fibers within various size lymphocytes and plasma cells were diffusely distributed. The red pulp of the spleen was formed from venous sinuses and anastomosing cord of reticular cells, macrophages, lymphocytes and blood cells. The length and breadth of the thymic lobules, bursal follicles and white pulp of the spleen were 226.68 and 165.78cm, 204.45 and 138.23cm, and 129.05 and 103.43cm respectively. The result of the present work revealed that the immunocompetent cells were arranged scatteredly or densely as an unorganized lymphatic nodules in the lymphoid tissues. The length and breadth of the thymic lobules were higher followed by bursal follicle and splenic white pulps were varied within the lymphoid tissues and even one another in indigenous ducklings. The results of the present study indicate that the architecture and distribution of lymphocytes and lymphoid follicles of ducklings is very close to the chicken and this study might be helpful to understand the changes in the frequency of the population of immunocompetent cells in drug induced, vitamin and mineral supplemented or hormone treated duck in future.DOI = http://dx.doi.org/10.3329/bjvm.v9i1.11212 Bangl. J. Vet. Med. (2011). 9(1): 53-58

Blunt splenic injuries are most frequently caused as a result of motor vehicle collisions and are associated with high mortality rates. In order to accurately assess the risk of automotive related spleen injuries using tools such as finite element models, tissue level tolerance values and suitable material models must be developed and validated based on appropriate biomechanical data. This study presents a total of 41 tension tests performed on spleen parenchyma coupons and 29 tension tests performed on spleen capsule/parenchyma coupons. Standard dog-bone coupons were obtained from fresh human spleen and tested within 48 h of death. Each coupon was tested once to failure at one of the four loading rates to investigate the effects of rate dependence. Load and acceleration data were obtained at each of the specimen grips. High-speed video and optical markers placed on the specimens were used to measure local displacement. Failure stress and strain were calculated at the location of failure in the gage length of the coupon. The results of the study showed that both the spleen parenchyma and the capsule are rate dependent, with higher loading rates yielding higher failure stresses and lower failure strains. The results also show that the failure stress of the splenic capsule is significantly greater than that of the underlying parenchyma. Overall, this study provides novel biomechanical data that demonstrate the rate dependent tissue level tolerance values of human spleen tissue in tensile loading, which can aid in the improvement of finite element models used to assess injury risk in blunt trauma.

This report presents the case of a 70-year-old woman with a previous history of a left nephrectomy for renal cell carcinoma (RCC), who developed general malaise and fatigue. Abdominal computed tomography demonstrated an enhancing 6 × 7 cm necrotic lesion in the lower pole of the spleen suggestive of a metastasis. Given the highly suspicious nature of the lesion we proceeded to splenectomy. The tumour did not breach the splenic capsule, and there was no local diaphragmatic involvement. The mass was concluded to be a true metastasis of the original RCC rather than local recurrence of the disease. The causes of isolated solid splenic lesions are wide and varied, however a past or present history of malignancy should lead to a high index of suspicion for a splenic metastasis. We report an extremely unusual case of spread from a RCC.

Estudou-se a viabilidade do autotransplante de tecido esplênico, um terço do baço, associado à esplenectomia parcial, e verificou-se a cinética evolutiva de sua regeneração, sob o aspecto macroscópico e histológico. Foram utilizados 28 ratos Wistar, adultos, machos, com média de peso de 300g, distribuídos em quatro grupos experimentais. Cada animal foi submetido à esplenectomia parcial, e um fragmento de baço foi transplantado para o omento maior, por períodos de 30, 60, 90 e 120 dias. Após cada período pré-estipulado, os tecidos esplênicos autotransplantados foram coletados e analisados histologicamente. Os resultados mostraram regeneração da cápsula esplênica, dos vasos sanguíneos e das polpas branca e vermelha. Aos 90 dias, a arquitetura microscópica apresentava-se semelhante à do baço normal.

We report a case of spontaneous splenic rupture (SSR) caused by a Bacillus species (sp.) infection. A 36-year-old man on warfarin therapy since an aortic valve replacement at the age of 13 was admitted to our hospital with a 3-week history of a high fever. He had been asymptomatic until 4 months previously, when he suffered a cerebral embolism despite adequate oral anticoagulation. Abdominal computed tomography revealed splenic infarctions, which resulted in splenic rupture 2 days later. After embolization of the splenic artery, splenectomy was successfully performed. Pathologic examination revealed splenic infarction, resulting from septic emboli, with associated rupture of the splenic capsule, but no abscess was found. Bacillus sp. was isolated from cultures of arterial blood preoperatively, and the excised splenic specimens, postoperatively. In addition to rupture of the suppurating intrasplenic vessels with hematoma formation, the anticoagulant therapy possibly contributed to distension of the intrasplenic hematoma.

A case of endosalpingiosis appearing as a huge multilocular cyst in the spleen of a 31-year-old woman is reported. The cystic lumens were smooth, and lined by fallopian tubal epithelium containing ciliated and secretory cells. The epithelial lining showed neither atypia nor foci of papillary proliferation, with only 3-5% MIB-1 labeling index. The epithelial lining was histochemically negative for mucin, but positive for MUC1 and progesterone receptor. Despite the appearance of a tumor-like mass, it was diagnosed as florid cystic endosalpingiosis as there was a normal tube-like epithelium. Regarding etiology, it was considered to derive from the secondary mullerian system of the splenic capsule.

In the summer of 2001, Usutu virus (USUV) was isolated for the first time in Europe, from an episode of mass mortality in Eurasian blackbirds (Turdus merula). In the present study, 40 of the birds (representing three species), confirmed as cases of USUV infection, were examined by four methods (histopathology, immunohistochemistry [IHC], in-situ hybridization [ISH] and reverse-transcriptase polymerase chain reaction [RT-PCR]). The major macroscopical finding was hepatosplenomegaly; histologically, neuronal necrosis, myocardial lesions, and coagulative necrosis of the liver and spleen were observed. IHC with cross-reactive polyclonal antibodies to West Nile virus detected viral antigen predominantly in brain neurons (40/40 birds; 100%), myocardial fibres (25/32; 78%), cells of the splenic capsule (29/33; 88%), renal glomeruli (22/35; 63%), tunica muscularis of intestines (17/22; 77%), proventricular glands (16/19; 84%), lungs (18/33; 55%) and hepatic Kupffer cells (7/38; 18%). ISH with an USUV-specific oligonucleotide probe demonstrated viral nucleic acid predominantly in brain neurons (40/40; 100%), myocardial fibres (24/33; 73%), splenic macrophages (12/34; 35%), renal tubular cells (19/36; 53%), tunica muscularis of intestines (13/32; 41%), proventricular glands (19/22; 86%), lungs (7/34; 21%) and hepatic Kupffer cells (12/38; 32%). All of 33 birds tested additionally by USUV-specific RT-PCR gave positive results.

The presence and intraorgan distribution of the acetylcholinesterase (AChE)- positive nerve structures in the guinea-pig spleen were studied by means of the direct thiocholine method. Visualized AChE-positive nerve fibres entered the guinea-pig spleen at its hilum in the vicinity of the splenic artery branches and intra parenchyma were gradually distributed to form thicker periarterial nerves and also fine adventitial nerve plexus. In described topography the AChE-positive nerve fibres were identified in association with the central artery running through the white pulp. Some of the perivascular nerve fibres associated with the central artery extended away and passed into the periarterial lymphatic sheath (PALS) to reach the marginal zone and in continuation entered into the mantle zone of lymphatic follicles. Several AChE-positive nerve fibres were seen in the red pulp but less in the splenic capsule. We did not find any AChE – positive nerve cells in the guinea-pig spleen.

Laparoscopic splenectomy (LS) is an alternative to open surgery. However, there is a theoretic risk of splenosis and abdominal cavity dissemination of splenic cells if the splenic capsule is broken, as seen by experimental evidence of tumoral cell mobilization by the pneumoperitoneum. We evaluated the features of splenosis after splenectomy operated via an open approach or under laparoscopic control in an experimental model in the rat. A total of 65 Sprague-Dawley rats were distributed in seven groups that included the open approach, CO2 pneumoperitoneum LS, or wall lift LS with or without a splenic graft. Splenic function was evaluated 90 day later through (1) scintigraphy with Tc-labeled heat-damaged erythrocytes; (2) determination of circulating "pitted" cells; and (3) analysis of the distribution of splenic pulp in the peritoneal cavity. Scintigraphy did not show viable residual tissue in any group after splenectomy; splenic activity in the splenic fossa was observed in 40% of the animals with grafts. Splenectomy increased the "pit" cell count, but it was reduced to normal values with a splenic graft. Necropsy showed normal splenic tissue in the splenic fossa in 100% of animals with a graft. Abdominal implants were observed significantly more frequent after CO2 LS than after the open surgery or a wall lift LS (80% vs. 20% vs. 30%; p0.05). In addition, trocar site implants were observed with CO2 LS (n = 3) or wall lift LS (n = 2), whereas there were no implants in the wound in the open group. We conclude that in an experimental rat model the pneumoperitoneum may facilitate abdominal splenosis after LS if the splenic capsule is ruptured or if splenic tissue spills compared with surgery without gas (open or laparoscopic).

Background Laparoscopic cholecystectomy (LC) is generally safe and well-accepted. In rare cases, it is associated with complications (intra- e postoperative bleeding, visceral injury and surgical site infection). Splenic lesion has been reported only after direct trauma. We report an unusual case of splenic rupture presenting after “uncomplicated” LC. Case presentation A 77-year-old woman presented with distended abdomen, tenderness in the left upper quadrant and severe anemia 12 hours after LC. Clinical examination revealed hypovolemic shock. Abdominal computed tomography confirmed the diagnosis of splenic rupture, and the patient required an urgent splenectomy through midline incision. The post-operative course was uneventful and the patient was discharged on 7th postoperative day. Splenic injury rarely complicates LC. We postulate that congenital or post-traumatic adhesions of the parietal peritoneum to the spleen may have been stretched from the splenic capsule during pneumoperitoneum establishment, resulting in subcapsular hematoma and subsequent delayed rupture. Conclusions Splenic rupture is an unusual but life-threatening complication of LC. Direct visualization of the spleen at the end of LC might be a useful procedure to aid early recognition and management in such cases.

Aim : The authors studied changes in splenic volume after partial splenic embolization (PSE) in children who had thrombocytopenia caused by splenomegaly. Materials and Methods : Five children with hypersplenism (ages of 1, 6, 7, 10, and 14 years) underwent PSE. The follow-up period ranged from 1 month to 8 years 9 months. Whole and infarcted splenic volumes were measured from computed tomography images obtained before and after PSE. Results : Within 2 weeks after PSE, the whole splenic volume increased to 110% to 140% of the pre-PSE volume. The infacted area disappeared 3 to 4 months after PSE, and the whole splenic volume decreased markedly. The decreased volume tended to be stable during the follow-up period. The splenic enlargement before PSE ranged from 7.2 to 14.2 times the standard splenic volume for a corresponding body weight. The splenic volume did not become normal after PSE; it remained between 2 and 7 times larger than standard. Platelet counts stayed above 10 × 10 4 /mm 3 when the splenic volume reduced to 2 times the standard volume. Conclusion : The first 4 weeks after PSE is the most dangerous period for the development of splenic rupture because of marked expansion of the splenic capsule. The infarcted parenchyma is absorbed 3 to 4 months after PSE, and the whole splenic volume is reduced. Thereafter, the splenic volume is stable for several years. Reembolization is not likely to be necessary in the majority of patients who have had splenic embolization with an infarction rate of ≥80%.

Knowledge of the unique splenic anatomy is essential to guide surgical therapy. The spleen develops within the dorsal mesogastrium during the fifth week of gestation and is located in the left upper quadrant of the abdomen. It abuts the diaphragm superiorly, posteriorly, and laterally. The visceral relationships of the spleen include the left kidney, splenic flexure of the colon, stomach, and tail of the pancreas. The splenic capsule is covered by parietal peritoneum, except at the splenic hilum, and the peritoneum forms its suspensory ligaments.

The aim of this study was to investigate whether complications occur after haemostatic agents are injected into blunt splenic injuries. After undergoing ultrasound (US), contrast-enhanced US (CEUS) and contrast-enhanced computed tomography (CECT) examinations, dogs with grade III–IV injury received the minimally invasive therapy. After treatment, CEUS was performed to observe changes in the regions treated. In the immediate group, dogs underwent laparotomy 30 min after treatment to observe the haemostatic effect. In the survival group, animals underwent CEUS and CECT examinations to observe the short-term healing outcome and complications at 3, 7, 14, and 21 days after the injection. After undergoing CEUS and CECT examinations, 12 dogs with grade III-IV injury received the minimally invasive therapy. Before injection, CEUS examinations showed anechoic and/or hypoechoic perfusion defects and active bleeding at the injury sites, and CECT showed traumatic lesions as low-density regions without enhancement. After treatment, CEUS demonstrated the disappearance of active bleeding, and hyperechoic spots emerged at the injury sites. Uneven density regions were displayed on CECT. Treated areas were covered by blood clots and glue membrane in the immediate-group animals. Three weeks later, CEUS showed a decrease of hyperechoic spots in the survival group, and the splenic parenchyma enhanced uniformly on CECT. Laparotomy showed that the greater omentum had moved upwards and partly covered the wound in four animals, and the injury sites had completely healed. Histopathological examination showed that fibrous connective tissue covered the splenic capsule and that the haemostatic glue had degraded. No complication occurred, such as delayed splenic haemorrhage, splenic abscesses, splenic pseudoaneurysms, intestinal obstruction or intestinal adhesions. CEUS-guided haemostatic injection is not only effective in stopping active bleeding immediately, but it is also safe in that no complications occurred during the 3 weeks of follow-up. This study indicates that CEUS-guided percutaneous injection may provide a safe, feasible and effective therapy for blunt splenic trauma.

We describe herein a clinical case in which a subcapsular splenic hematoma complicated chronic relapsing pancreatitis. A pathogenetic mechanism is postulated that explains the subacute insorgence of the liquid collection with the diffusion of proteolytic enzymes between the splenic capsule and parenchyma. Radical therapy, consisting of exeresis of the cystic formation, splenectomy and caudal pancreatectomy, is recommended for this extremely rare complication.

This paper describes the ultrasonographic appearance, location and size of the spleen in 50 healthy commercial milk cows destined for slaughter. The intercostal spaces of the left thoracic wall were scanned with a 3.5 MHz linear transducer. In each intercostal space, the appearance of the splenic parenchyma, the dorsal and ventral margins and the distance between them, and the diameter of the splenic vessels were recorded. The spleen was seen in intercostal spaces 7-12. It was 2.0-5.0 cm thick, and tapered ventrally. The splenic capsule appeared as an echogenic line. The splenic parenchyma consisted of numerous small regularly spaced echoes, and vessels within the parenchyma appeared as anechoic round to oval or elongated images. The long axis was oblique, running caudodorsal to cranioventral. The distance from the dorsal margin of the spleen to the midline of the back was greatest in the 7th intercostal space (60.9+/-6.81) and smallest in the 12th intercostal space (12.7+/-2.85 cm). The extent of the spleen was greatest in the 8th intercostal space (24.9+/-10.77 cm) and smallest in the 12th intercostal space (9.5+/-5.38 cm). The mean diameter of the splenic vessels ranged from 0.66+/-0.28 to 0.90+/-0.65 cm, depending on the intercostal space scanned. Ultrasonography of the spleen in healthy cows provides information that can be used as a reference when examining cattle with suspected splenic disease.

An 18-year-old woman with abdominal pain was diagnosed as having splenic cysts by computed tomography scan. She had high serum levels of CA19-9 (2886.8 U/mL; normal value

Many mammals have the ability to autotransfuse a large quantity of red blood cells from the spleen into the active circulation during times of stress. This enhancement of the oxygen transport system has benefited the athletic mammal, that is, the thoroughbred horse, fox and greyhound in an improved aerobic performance. The role of the spleen in sequestering 50% of the total red cell volume in seals and horses, during times of inactivity, dramatically reduces the viscosity of the blood and therefore the work of the heart. In comparison, the human spleen contains only a small percentage of red blood cells, and has been primarily thought of as a lymphoid organ. The aim of this review is to emphasise the similarities between the human spleen and that of several athletic mammalian species during acute physiological stress. In the athletic mammalian model the expulsion of blood from the spleen is facilitated via the sympathetic nervous system resulting in contraction of smooth muscle within the splenic capsule. In comparison, the lack of smooth muscle contained within the human splenic capsule has meant that active contraction of the spleen has historically been viewed as unlikely, although evidence of contractile proteins within the red pulp have suggested otherwise. Exercise results in haemoconcentration, which has been attributed solely to a reduction in plasma volume. Indirect calculation of plasma volume changes utilise haemoglobin and haematocrit and assume that the circulating red cell volume remains constant. However, several studies have suggested that the human spleen could account for 30% of the increase in haematocrit. This would result in a substantial overestimation of the reduction in plasma volume, indicating that the expulsion of red blood cells from the spleen must not be overlooked when utilising these equations.

The fiber arrangement of the rat splenic capsule was examined under scanning electron microscope (SEM) after selective removal by chemical maceration of capsule components, in conjunction with examination of thin sections using a transmission electron microscope (TEM). TEM findings were compared to those of the guinea-pig, mouse and dog. Serosal cells of the rat splenic capsule showed labyrinthic channels that consisted of expanded intercellular spaces and tunnel-like spaces or slits in the basal cytoplasm. The channels contained fascicles of collagenous fibrils, forming a loose net on an underlying elastic lamina of densely aggregated elastic fibers. The fibrous tunica was an intermingled layer of elastic and collagenous fibers and sparse interstitial cells. The fibrous components were arranged more densely in the external layer than in the internal layer of the capsule. The elastic lamina comprised the outermost layer of the fibrous tunica in the intertrabecular region, but was situated deep in the trabecular region. Outward branches of the lamina in the trabecular region were arranged in a spiral. Intrachannel fibrillar fascicles were continuous, via fenestrations in the elastic lamina, with thick fascicles of collagenous fibers. The elastic lamina may play a role in effective contraction of whole spleen. In the guinea-pig, mouse and dog, elastic fibers were fragmented and not arranged in laminae. Typical smooth muscle cells were abundant in the dog. The channel spaces in the serosal tunica are discussed from the viewpoint of extravascular lymphatic flow for circulation of the peritoneal serous fluid.

We present a case of an atraumatic, occult rupture of the spleen. It is only in a distinct minority of cases, that the splenic capsule remains intact, thereby preventing intraperitoneal bleeding. Nevertheless, this condition can be accompanied by a severe loss of blood. A nonoperative management can be considered. Reviewing the literature on splenic rupture, the lack of uniformity in nomenclature is striking. The etiological and morphological classifications are reviewed.

The mammalian spleen show peculiar histological differences. This study aims to compare the gross, histologic and histomorphometrics of the spleen of Nigerian indigenous pig, NIP (Sus scrofa) and West African Dwarf goat (WADG). Twenty spleens (10 each) from apparently healthy slaughtered adult pigs and goats were studied. Sections were neutral buffered formalin fixed and paraffin embedded for routine and special stains. Grossly, WADG spleen was quadrangular but slipper shaped in NIP. The difference in splenic length and weight in NIP (36.87±2.71cm and 180±17.32cm) was significant (P< 0.05) compared to WADG (9.2±0.77cm and 68±5.43cm). WADG has significantly thickened splenic capsule (1173±57.02µm) than NIP (271.8±17.08µm) (P

This study was designed to compare Nd:YAG laser to fibrin glue, electrocautery, and avitene in the management of superficial splenic injury. Six dogs were submitted to laparotomy. A #11 blade scalpel was used to sharply excise the splenic capsule inflicting four 1″ × 1″ superficial injuries on each spleen. The lesions were treated. All animals had a second laparotomy (“first relaparotomy”); 2 dogs each were reexplored on postop days 3, 7, and 14. Morphologic and histologic observations were made. A third and final relaparotomy was performed on all dogs at 21 days with repeated morphologic and histologic assessments. Hemostatic times, grades of adhesions, and microscopic changes were not significantly different among the various treatments (P > 0.25). Capsular plaque formations were significantly different at the first relaparotomy (P < 0.01) and at final relaparotomy (P < 0.05). Both adhesions and capsular plaque formation were least at fibrin glue-treated sites, whereas Nd:YAG (1.06 μm) was most effective for average hemostatic time (mean = 109.67 s). Electrocautery produced the greatest necrosis at treatment sites. We conclude that all modalities are effective in controlling hemorrhage. © 1994 Wiley-Liss, Inc.

The diagnosis of Delayed Splenic Rupture poses a major challenge to even the most astute clinician, as it can mimic other medical emergencies. We present a case of an unusual presentation of delayed splenic rupture in a 23-year-old Caucasian man, who presented to the emergency department with a 2 day history of left upper quadrant pain. He initially denied any history of trauma. There were no signs of generalized peritonisim on examination but his haemoglobin level was low (8.9 gm/dl) for which there was no obvious cause identified. He was resuscitated and a computed tomography of the abdomen was performed. This revealed complete rupture of the splenic capsule with haemorrhagic fluid in the abdomen. With the computed tomography abdomen findings and further questioning of the patient, the only potential precipitating event that he could remember was a minor kick to the left upper quadrant more than 2 weeks ago while playing football. An urgent splenectomy was performed and histology confirmed complete rupture of the splenic capsule with a large adherent haematoma to the capsule. This case illustrates the difficulty in diagnosing delayed splenic rupture especially when accurate history is not available. A high index of suspicion is essential as delay in diagnosis can be fatal. Early diagnosis in suspected cases can be achieved by performing computed tomography of the abdomen.

Splenic vascular casts of the common tree shrew, Tupaia glis, were constructed with Batson's No. 17 plastic mixture and studied with the scanning electron microscope (SEM). Fifteen adult animals of both sexes, weighing between 120 and 180 g were used. Under ether anaesthesia, each animal was injected with 0.05 ml heparin intracardially; the right atrium was cut open and then 250 ml of 0.9% NaCl, followed by 50 ml of 10% neutral formalin, (in four animals) was injected through the left ventricle. Plastic mixture was injected through the same opening. After complete polymerization of the plastic, the spleen and surrounding tissues were removed and macerated in 40% KOH. The air-dried casts were then coated with carbon and gold before viewing and photographing under SEM at 15 kV. It was found that the splenic arteries penetrated deep into the organ before they divided into trabecular arteries and divided again into central arterioles. Each central arteriole sent out 15 to 30 radiating arterioles, called penicillar arterioles, and further divided into smaller vessels entering the marginal zone and red pulp. In this area each arteriole continued directly into either marginal or red pulp sinusoids. The sinusoids emptied into pulp venules which joined to form trabecular veins. Most of the trabecular veins travelled to the cortical area underneath the splenic capsule before approaching the hilum, where they finally drained into splenic and short gastric veins. It is likely that the spleen of the common tree shrew has a closed circulation.

pedicle. The condition is associated with other congenital abnormalities including the prune-belly syndrome, in which dilatation of the genitourinary tract interferes with gut rotation and fusion of the dorsal mesogastrium7. Some have suggested that it is the abnormal laxity of the splenic ligaments that is the primary aetiology8. An excess incidence in child-bearing years and in the multiparous has raised the possibility of ligamentous lengthening as a cause. Increased splenic mass has also been proposed as a possible aetiology but data regarding malarial and lymphomatous splenomegaly are conflicting; in most patients with a wandering spleen there is nothing wrong with the spleen itself9. Many patients with a wandering spleen are symptomfree, the condition being discovered incidentally on abdominal examination. Intermittent abdominal pains are a common mode of presentationl. Severe and persistent abdominal pain suggests splenic torsion which may vary from 90 to 160 degrees. Delay in diagnosis risks not only splenic infarction but also pancreatic necrosis10. How should a symptomatic wandering spleen be managed? At one time the favoured treatment was splenectomy, but this operation is now avoided when possible because of the spleen's important role in the reticuloendothelial system; therefore there is renewed interest in splenopexy. Torsion of the spleen and consequent infarction still necessitates splenectomy. All patients undergoing elective splenopexy should undergo pneumococcal vaccination in case the need for splenectomy should arise during splenopexy. Of the splenopexy techniques describedll, suturing of the spleen is said not to be complicated by haemorrhage though some feel this applies only to paediatric splenopexy where a thicker splenic capsule is more forgiving12. Our approach, whereby a Prolene pouch is fashioned and secured in the left upper quadrant, is novel. The spleen can then be easily placed within and the pouch closed thus securing the spleen in its correct anatomical position.

Fibrosarcoma of the spleen are generally single lesions and vary in size from a few millimeters up to several centimeters in diameter. Most lesions cause the splenic capsule to bulge, but smaller lesions may occasionally be embedded in the splenic parenchyma and cause little or no external distortion. Rarely, these neoplasms appear to be associated only with the deep surface of the capsule with little evidence of extension into the parenchyma. Such lesions have been designated capsular sarcomas.

Spontaneous rupture of the spleen is an uncommon dramatic abdominal emergency that requires immediate diagnosis and prompt surgical treatment to ensure the patients survival. Infections have been cited in most cases involving splenic rupture but are rare in hematological malignancies despite frequent involvement of the spleen. We present a case of a splenic rupture caused by infiltration of B-cell lymphoma. A 43 year old gentleman presented with a 1 day h/o left upper quadrant pain; nausea and vomiting for 2 days with associated dizziness and anorexia. The CT showed abnormal spleen 20 × 11 cm with free fluid in the abdomen and enlarged retroperitoneal LNs. The patient underwent a splenectomy after initial resuscitation and the operative finding was that of a massively enlarged spleen with areas of tumor extruding through the splenic capsule. Although the spleen is often involved in hematological malignancies, splenic rupture is an infrequent occurrence. In a recent literature review 136 cases were of splenic rupture secondary to hematological malignancy were identified. Acute leukemia and non Hodgkin lymphoma were the frequent causes followed by chronic myelogeneous leukemia. Male sex, adulthood, severe splenomegaly and cytoreductive chemotherapy were factors more often associated with splenic rupture. Emergency splenectomy remains the cornerstone treatment for splenic rupture. We present a case report of a "spontaneous splenic rupture" and discuss the presentation, etiology and treatment options along with discussion of relevant literature

The two peptides, neuropeptide Y (NPY) and peptide YY (PYY) were compared for potency on the vascular and extravascular smooth muscle of the isolated, blood-perfused spleen of the dog. The only vascular response to both NPY and PYY was vasoconstriction; the maximum effect was to arrest splenic arterial blood flow completely. On a molar basis both NPY and PYY were significantly more potent (P less than 0.01) as splenic arterial vasoconstrictors than the transmitter noradrenaline (NA). PYY was approximately 7 times more potent as a vasoconstrictor than NPY. In contrast to their potency on the vascular smooth muscle, NPY and PYY were significantly (P less than 0.01) less potent than NA in causing contraction of the splenic capsule. The two peptides were equipotent in eliciting this contraction.

A study was made of the sites of development and the types of cells found in very early hemopoietic colonies in the mouse spleen. Two, 3, and 4 days after transplantation, the proliferating descendants of transplanted bone-marrow cells were identified on radioautographs of spleen sections and on spleen and bone-marrow smears of supralethally irradiated recipient mice which were injected with 3H-TdR at 12, 6, and 0.5 hours before sacrifice. Surprisingly the spleens of nontransplanted, irradiated mice contained proliferating medium and large lymphocytes in the white pulp which increased in numbers during the observation period. The early descendants of transplanted cells that lodged in the spleen could be clearly distinguished from the labeled indigenous cells because they formed discrete nodules or colonies beneath the splenic capsule or in the vicinity of venules and trabeculae of the red pulp. These cells were identifiable on day 2 as transitional cells or unknown hemopoietic blasts and on day 4 included early erythroid cells and small lymphocytes. There was evidence for the traffic of 3H-TdR-labeled cells through the splenic sinusoids.

Pathologic rupture of the spleen is a rare phenomenon in acute lymphocytic leukemia, and its mechanism is unknown. This complication has been seen almost exclusively in men, and at ages much older than those of the majority of patients who have this leukemia; these unusual features are also unexplained. A case of acute lymphoctyic leukemia with pathologic rupture of the spleen in which the pathologic findings suggest that the splenic rupture was due to infiltration and destruction of the splenic capsule by leukemic cells is reported.

Two patients with rheumatoid arthritis without splenomegaly or Felty's syndrome developed spontaneous rupture of the spleen. The histological appearance was consistent with involvement of the splenic capsule by the rheumatoid process, and this may have predisposed to splenic rupture.

Vascular characteristics of the splenic vein are entirely different from the portal vein in the dog. We compared the responsiveness of the splenic capsule, which contains abundant smooth muscle with the portal and splenic veins. With respect to potentiation of acetylcholine-induced contraction by neostigmine, the relaxation response to isoproterenol and the contractile response to 5-hydroxytryptamine, the splenic capsule differed from the splenic vein, but was rather similar to the portal vein. A site of morphological and pharmacological discontinuity between the portal vein and the splenic vein occurred at the junction of the splenic vein and the left gastric vein to form the gastrosplenic vein. This junction may coincide with the site of connection of the embryonic splenic vein, a newly formed efferent vein of the spleen, with the portal vein, which was reported by Miki [cf. Bevan et al.: 4th Int. Symp. on Vascular Neuroeffector Mechanisms; Raven Press, New York 1983]. On the splenic side, histological examination revealed that smooth muscle of the splenic capsule and trabeculae are interconnected, but did not extend to the splenic vein. At openings of the trabecular veins into the ‘intrasplenic’ portion of the splenic vein the trabecular smooth muscle continued to the extended capsule. The site of change in pharmacological responses was also found to be located between the trabeculae and the intrasplenic portion of the splenic vein. Thus the splenic vein can be regarded as a distinct segment of vessel inserted between the portal vein and the spleen. This may reflect differences in embryogenesis of their smooth muscle.

1. Experimental observations on three types of autotransplantation of spleen tissue into omental pouch are reported. Implanted slices and fragments of spleen could preserve certain function. Survival rate of transplants was 100 %. 2. Several factors influencing implant are discussed, such as optimal site for implantation, problem of removal of splenic capsule, volume of transplants, and spleen perfusion. Regenerated slices and fragments seen in a series of exploratory laparotomy and histologic changes are described. 3. We recommend that autotransplantation of splenic slices together with fragments and arrangement of slices in the form of U figure into the omental pouch created by folding be used clinically. The technique is simple, safe and free of complications.

The number of beta-adrenoceptors in myocardium and spleen from 6-hydroxydopamine (6-OH-DA) treated cats was determined by radioligand binding with [125I]-iodohydroxybenzylpindolol (IHYP). The effectiveness of 6-OH-DA pretreatment was assessed by analyses of the tissue content of catecholamines and the contractile response of isolated splenic strips to electrical stimulation. Since no effect on the splenic strip was produced by the beta-agonist isoprenaline, whereas noradrenaline caused contraction, it is concluded that the smooth muscle of the splenic capsule is controlled by postjunctional alpha-adrenoceptors. The number of specific IHYP binding sites were reduced by 70% in whole spleen tissue and totally abolished in the splenic capsule by pretreatment with 6-OH-DA. Subclass analysis revealed that the reduction in total splenic beta-adrenoceptor number was due to a loss of beta 2-adrenoceptors. However, the 6-OH-DA induced chemical sympathectomy did not produce any alteration either in beta-adrenoceptor density or the relative distribution of the beta-adrenoceptor subtype in the myocardium. It is suggested that a loss of prejunctional beta-adrenoceptors, due to chemical sympathectomy, might be compensated for by an increased number of postjunctional beta-adrenoceptors in the myocardium due to the development of denervation supersensitivity in this tissue. In conclusion, the findings provide direct biochemical evidence for existence of prejunctional beta 2-adrenoceptors on the sympathetic nerve terminals of the cat spleen.

1. Reflex changes in wall tension of the lateral saphenous vein of one hind limb, the splenic veins and capsule, and the resistance vessels of the other hind limb caused by changes in baroreceptor activity were measured in vagotomized dogs under thiopentone-chloralose anaesthesia. 2. Three different methods were used to alter pressure in one or both carotid sinuses. (1) Both carotid sinuses were vascularly isolated and filled with fully oxygenated Krebs—Ringer bicarbonate solution (pH 7·4) from a reservoir in which the pressure could be altered at will. (2) One sinus was denervated, and the contralateral sinus was perfused with arterial blood at different flow rates. (3) One sinus was denervated, and the innervated sinus was perfused with arterial blood at constant flow, the pressure being altered by changing the outflow resistance. 3. The left saphenous vein was perfused at constant flow with autologous blood; changes in perfusion pressure were used as a measure of changes in veno-motor activity. The right common iliac artery was perfused at constant flow to measure changes in resistance vessel activity. Blood flow through the spleen was temporarily arrested, trapping a fixed volume of blood in the organ. Under these conditions, changes in splenic vein pressure were a measure of changes in smooth-muscle tension in the splenic capsule and veins. 4. In order to assess the responses to baroreceptor stimulation in terms of alterations in sympathetic nerve traffic to different components of the peripheral vascular system, ‘frequency—response curves’ were constructed for spleen, saphenous vein, and limb resistance vessels by electrical stimulation of the splenic nerves and lumbar sympathetic chains. 5. The saphenous vein showed no consistent response to changes in baroreceptor activity. Reduction in carotid sinus pressure from 180 to 100 mm Hg caused an increase in venous pressure in the isovolumetric spleen and in the iliac artery perfusion pressure. These results were confirmed by electrical stimulation of the carotid sinus nerve. Whereas the peak responses of the limb resistance vessels corresponded to an increase in lumbar sympathetic nerve traffic of 6–10 c/s, the maximal splenic responses were equivalent to an increase in splenic nerve traffic of 1-4 c/s. These results are consistent with selective autonomic nervous control of different components of the peripheral vascular system.

The use of a nasogastric tube to empty the stomach contents prevents compression of the splenic parenchyma and allows clear visualization of the anterior medial border of the spleen and perisplenic area. Unsuspected superficial lacerations or a contained hematoma by the splenic capsule may become apparent only following this procedure. A representative case is reported. Routine application of this simple procedure aids avoiding occasional pitfalls and helps in early diagnosis of splenic injury at the time of a CT study.

Field stimulation of strips of canine splenic capsule and splenic artery suspended in an organ bath causes in both a contraction that is enhanced by cooling from 37 degrees C to 27 degrees C. This finding contrasts with that from the isolated perfused canine spleen in which cooling to 27 degrees C enhanced the vascular response to splenic nerve stimulation but depressed the capsular response. The results of experiments to resolve the apparent discrepancy in the capsular smooth muscle response to stimulation indicate that the reduced response in the perfused spleen probably results from the capsular smooth muscle fibres being less optimally placed on their length: tension curve at 27 degrees C when spleen volume is less. There is thus no need to postulate any fundamental difference in properties between the smooth muscles from the two intrasplenic distributions.

Splenic pseudocysts have traditionally required splenectomy because of the risks imposed by partial splenectomy or excision of the cyst lining. During the past 2 years, a 6-year-old boy and a 9-year-old girl presenting with vague upper abdominal discomfort, palpable splenomegaly, and a large unilocular sonolucent cyst within the spleen, were treated by partial splenic decapsulation with preservation of the hilar blood supply. This procedure involves (1) mobilizing the spleen by dividing the renal, colic, and diaphragmatic attachments; (2) decompressing the liquefied cyst contents through a thoracostomy trochar; (3) excising the outer splenic capsule and gaining hemostasis of the splenic wall with a running interlocked silk suture; and (4) providing external tube drainage of the left upper quadrant. During the follow-up period of 26 and 12 months, splenic size has returned to normal. Serial nuclear scan and ultrasound show a small residual crescent-shaped deformity of the functioning splenic remnant. We conclude that partial splenic decapsulation for splenic pseudocyst is simpler and safer than other preservation procedures attempted, and carries no increased risk of recurrence from leaving a portion of the pseudocyst wall.