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1、CHAPTER57THESPLEENJulieSheltonandMichaelD.Holzmansplenicvesselsastheybranchwithintheorganandmergewithsplenicanatomythesetrabeculae.Thearteriolesbranchintoevensmallervesselssplenicfunctionandleavethesetrabeculaetomergewiththesplenicpulp,wheresplenectomytheiradventitiais
2、replacedbyacoveringoflymphatictissuethatlatemorbidityaftersplenectomycontinuesuntilthevesselsthintocapillaries.Theselymphaticprophylactictreatmentofsplenectomizedpatientssheathsmakeupthewhitepulpofthespleenandareinter-spersedamongthearteriolarbranchesaslymphaticfollicl
3、es.Thewhitepulptheninterfaceswiththeredpulpatthemarginalzone.ItisinthismarginalzonethatthearterioleslosetheirSPLENICANATOMYlymphatictissueandthevesselsevolveintothin-walledsplenicThespleenisan80-to300-gorganthatinitiallydevelopsfromsinusesandsinusoids.Thesinusoidsthenm
4、ergeintovenules,mesenchymalcellsinthedorsalmesogastriumduringweek5ofdrainingintoveinsthattravelalongthetrabeculaetoformembryogenesisandsettlesintotheleftuppermostaspectofthesplenicveinsthatmirrortheirarterialcounterparts.Thesplenicabdomen.Itssuperiorsurfaceisroofedbyth
5、ediaphragm,sepa-veinleavesthesplenichilum,travelsposteriorlytothepancreas,ratingitfromthepleura.Itshouldbenoted,however,thatthejoiningwithpancreaticbranchesandoftentheinferiormesen-costodiaphragmaticrecessextendstotheinferiormostaspectoftericveintofinallyreceivethesupe
6、riormesentericveinforminganormal-sizedspleen.Thespleen’svisceralrelationshipsincludetheportalvein.thegreatercurvatureofthestomach,splenicflexureofthecolon,apexoftheleftkidney,andtailofthepancreas(Fig.57-1).ItisSPLENICFUNCTIONprotectedbyribs9,10,and11andissuspendedinits
7、locationDuringfetaldevelopment,thespleenhasimportanthematopoi-bymultipleperitonealreflections,thesplenophrenic,gastro-eticfunctions,whichincludewhiteandredbloodcellproduc-splenic,splenorenal,andsplenocolicligaments.Inpatientstion.Thisproductionisusurpedbythebonemarrowb
8、ythewithoutportalhypertension,thesplenophrenicandsplenocolicfifthmonthofgestationand,undernormalconditions,theligamen
