Size: 10–12cm long, 6–7cm wide, 3–4cm thick (about fist sized)

The spleen weighs 150–200g.

In its normal size, it is not palpable.

The spleen is located intraperitoneally in the hypochondrium on the left side, at the height of ribs 9–11.

Its longitudinal axis runs approximately by rib 10 from top to bottom, from back to front, and from outside to inside.

The splenic bed is bordered caudally by the phrenicocolic ligament on the left.

diaphragm

stomach

left kidney and adrenal gland

transverse colon

phrenicocolic ligament on the left (= sustentaculum lienis)

pancreas

ribs 9–11 on the left

organ pressure

turgor

phrenicocolic ligament on the left

gastrosplenic ligament

splenorenal ligament (previously phrenicolienal ligament)

pancreaticosplenic ligament

Splenic artery (via the splenorenal ligament).

Splenic vein (via the splenorenal ligament).

Pancreaticolienal lymph nodes with connection to celiac, hepatic, and gastric lymph ducts.

Fig. 9.1 Location of the spleen at the height of ribs 9-11.

sympathetic nervous system from T5 to T9 via the major splanchnic nerve and switching in the celiac plexus

vagus nerve

Maximal time: 9–11 a.m.

Minimal time: 9–11 p.m.

Mobility

The spleen follows the movements of the diaphragm: during inhalation, we see a shift in a caudal-medial direction; during exhalation it is in the opposite direction.

The spleen’s position is also affected by shifts in body posture and changes in the tension and length of the phrenicocolic ligament on the left and the transverse colon. A full stomach similarly displaces the spleen anteroinferiorly.

removal of old or damaged blood cells (especially erythrocytes), thrombocytes, microorganisms, or immune complexes

antigen-induced differentiation and proliferation of B and T lymphocytes

storage of thrombocytes and erythrocytes

Definition. This term refers to an enlarged spleen. The increase in size can be so great that the spleen becomes palpable.

Causes. Splenomegaly is a possible symptom in different pathologies, such as:

blood and lymph diseases (lymphoma, leukemia, hemolytic anemia)

liver diseases (cirrhosis, hepatitis)

rheumatic disorders

storage disorders (e.g., amyloidosis)

infectious diseases (e.g., malaria, typhoid)

sarcoma

abscess

echinococcal cyst

Clinical. The spleen is palpable or diagnosable by technical means because it is enlarged.

In cases where the enlargement of the spleen is gradual, symptoms arise as a result of the displacement. In cases with a more rapid enlargement, we can see coliclike pain in the left upper abdomen radiating into the left shoulder.

As splenomegaly is often a secondary symptom, we must pay attention to other signs of disease.

Definition. The occurrence of anemia, granulocytopenia, or thrombocytopenia as the result of splenic hyperfunction. This hyperfunction frequently occurs together with a splenomegaly.