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Spleen

Organ supplied · LUQ / L shoulder

A mesodermal organ of the dorsal mesogastrium rather than a gut derivative, but supplied entirely by the terminal segmental branches of the splenic artery. These are end arteries, so occlusion produces wedge-shaped infarcts.

Traced from the start

  1. Abdominal aorta
  2. Coeliac trunk
  3. Splenic artery
  4. Spleen

Detail

Supply
Segmental end-arterial branches of the splenic artery at the hilum
Drainage
Splenic vein → joins SMV behind the pancreatic neck → portal vein
Referred pain
LUQ; left shoulder tip (Kehr's sign) via the phrenic nerve, C3–C5

When it goes wrong

Emboli (AF, endocarditis), sickle cell disease or myeloproliferative disorders occlude segmental end-arteries

Wedge-shaped splenic infarct: sudden LUQ pain, fever and a rub; Kehr's sign from diaphragmatic irritation

Blunt trauma to the left lower ribs

Splenic rupture: hypovolaemia, LUQ pain and Kehr's sign, sometimes delayed by days as a subcapsular haematoma expands

Practise this structure

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