J.O. Larkin, P.A. Carroll, P.H. McCormick, B.J. Mehigan: Control of splenic bleeding during splenic flexure mobilisation by devascularisation of the inferior pole of the spleen

Excerpt

The vascular anatomy of the spleen can vary greatly. Though the upper and lower poles are very often supplied by their own pole arteries, the segmental vascular distribution in the parenchyma is not clearly delimited. Intraparenchymal vascular connections prevent tissue death after the polar artery has been severed. Here, the sinusoidal structure of the parenchyma plays a central role, because the arteries ultimately empty into this sinus, where the veins have their origin. A change in pressure distribution due to lack of arterial supply causes reverse flow. The venous connections between the spleen segments are more pronounced than those of the arteries and so prevent necrosis if arterial flow stops [1]. Even transection of the artery and vein of one pole has no particular consequences; there is mostly atrophy of the segment involved, an infarction is rare. There is a risk of infarction only after complete occlusion of the main artery before the polar vessels arise, and they usually branch off several centimetres before the hilus. …