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Abdominal Radiology
Published in: Abdominal Radiology 2/2021

01-02-2021 | Pathology | Review

A review of anatomy, pathology, and disease spread in the perisplenic region

Authors: Ashley Etchison, Christine O. Menias, Dhakshina M. Ganeshan, Nikita Consul, Ayman Nada, Akram M. Shaaban, Ayman H. Gaballah, Sanaz Javadi, Khaled M. Elsayes

Published in: Abdominal Radiology | Issue 2/2021

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Abstract

The perisplenic region is a complex anatomical area involving multiple peritoneal and subperitoneal structures, which influence the presentation and behavior of various pathologic processes. This review is a comprehensive resource for perisplenic anatomy and pathology with associated clinical presentations and imaging findings. Understanding the pathophysiologic intricacies of the perisplenic region assists the radiologist in building a helpful differential diagnosis and recognizing predictable disease patterns.
Literature
1.
Meyers MA, Oliphant M, Berne AS, Feldberg MAM. The peritoneal ligaments and mesenteries: Pathways of intraabdominal spread of disease. Radiology. 1987;163(3):593-604.CrossRef
2.
Bentley-Hibbert S, Abdelbaki A, Elsayes KM. Cross-Sectional Imaging of the Spleen. In: Elsayes KM, ed. Cross-Sectional Imaging of the Abdomen and Pelvis: A Practical Algorithmic Approach. New York, NY: Springer New York; 2015:229–262.
3.
Pannu HK, Oliphant M. The subperitoneal space and peritoneal cavity: basic concepts. Abdom Imaging. 2015;40(7):2710-2722.CrossRef
4.
Sharma M, Rai P, Rameshbabu CS, Senadhipan B. Imaging of peritoneal ligaments by endoscopic ultrasound (with videos). Endosc Ultrasound. 2015;4(1):15-27.CrossRef
5.
Skandalakis PN, Celhorn GL, Skandalakis LJ, Richardson DD, Mitchell WE, Skandalakis JE. The surgical anatomy of the spleen. Surg Clin North Am. 1993;73(4):747-768.CrossRef
6.
Ostermann P, Schreiber H, Lierse W. [The ligament system of the spleen and its significance for surgical interventions]. Langenbecks Arch Chir. 1987;371(3):1207-1216.CrossRef
7.
Sharma M, Madambath JG, Somani P, et al. Endoscopic ultrasound of peritoneal spaces. Endosc Ultrasound. 2017;6(2):90-102.CrossRef
8.
Mortelé KJ, Mortelé B, Silverman S. CT Features of the Accesory Spleen. AJR. 2004;183:1653-1657.CrossRef
9.
Dogan NU, Uysal II, Demirci S, Dogan KH, Kolcu G. Accessory spleens at autopsy. Clin Anat. 2011;24(6):757-762.CrossRef
10.
Valls C, Monés L, Gumà A, López-Calonge E. Torsion of a wandering accessory spleen: CT findings. Abdom Imaging. 1998;23(2):194-195.CrossRef
11.
Termos S, Redha A, Zbibo R, et al. Torsion of huge wandering accessory spleen. Case report and review of literature. Int J Surg Case Rep. 2017;38:131–135.
12.
Sadro CT & Lehnert, BE. Torsion of an accessory spleen: Case report and review of the literature. Radiology Case Reports. 2013; 8(1):802.CrossRef
13.
Jang KM, Kim, SH, Lee, SJ, Park, MJ, Lee, MH, & Choi, D. Differentiation of an Intrapancreatic Accessory Spleen from a Small (<3-cm) Solid Pancreatic Tumor: Value of Diffusion-weighted MR Imaging. Radiology. 2013; 266(1), 159-167.CrossRef
14.
Raissaki M, Prassopoulos P, Daskalogiannaki M, Magkanas E, Gourtsoyiannis N. Acute abdomen due to torsion of wandering spleen: CT diagnosis. Eur Radiol. 1998;1412(8):1409-1412.CrossRef
15.
Lake, ST, Johnson, PT, Kawamoto, S., Hruban, RH, & Fishman, EK. CT of Splenosis: Patterns and Pitfalls. American Journal of Roentgenology. 2012;199: W686-W693.CrossRef
16.
Uy PPD, Francisco DM, Trivedi A, O’Loughlin M, Wu GY. Vascular Diseases of the Spleen: A Review. J Clin Transl Hepatol. 2017;5: 152-164.PubMedPubMedCentral
17.
Bedford PD, Lodge B. Aneurysm of the splenic artery. Gut. 1960; 1:312–320.CrossRef
18.
Moore SW, Guida PM, Schumacher HW. Splenic artery aneurysm. Bull Soc Int Chir. 1970; 29:210–218PubMed
19.
Pasha SF, Gloviczki, P, Stanson, AW, & Kamath, PS.. Splanchnic artery aneurysms. Mayo Clinic Proceedings. 2007; 82(4), 472-9.CrossRef
20.
Stanley JC, Thomas NW, Fry WJ. Splanchnic artery aneurysms. Arch Surg. 1970; 101:689–697.CrossRef
21.
Busuttil RW, Brin BJ. The diagnosis and management of visceral artery aneurysms. Surgery. 1980; 88:619–624.PubMed
22.
Stanley, JC, Wakefield TW, Graham LM, Whitehouse WM Jr, Zelenock GB, Lindenauer SM. Clinical importance and management of splanchnic artery aneurysms. J Vasc Surg. 1986; 3:836–840.CrossRef
23.
Trastek VF, Pairolero PC, Bernatz PE. Splenic ar- tery aneurysms. World J Surg. 1985; 9:378–383.CrossRef
24.
Agrawal G, Johnson P, Fishman E. Splenic Artery Aneurysms and Pseudoaneurysms: Clinical Distinctions and CT Appearances. AJR. 2007; 188:992–999.CrossRef
25.
Khosa F, Krinsky G, Macari M, Yucel EK, Berland, L. Managing Incidental Findings on Abdominal and Pelvic CT and MRI, Part 2: White Paper of the ACR Incidental Findings Committee II on Vascular Findings. J Am Coll Radiol. 2013;10:789-794.CrossRef
26.
Woods M, Traverso, L, Kozarek, R, Brandabur, J & Hauptmann, E. Successful Treatment of Bleeding Pseudoaneurysms of Chronic Pancreatitis. Pancreas. 1995;10(1), 22-30.CrossRef
27.
Cho KC, Patel YD, Wachsberg RH, Seeff J. Varices in portal hypertension: evaluation with CT. Radiographics. 1995;15(3):609-622.CrossRef
28.
Narra RK, Jehendran MV. Ruptured splenic abscess causing pneumoperitoneum: A rare cause revisited. BMJ Case Rep. 2015;2015:2014-2016.CrossRef
29.
Nunspeet L van. Uncommon cause of pneumoperitoneum. World J Gastrointest Surg. 2013;5(12):329.CrossRef
30.
Meyers MA, Charnsangavej C, Oliphant M. Intraperitoneal Spread of Infections and Seeded Metastases. In: Meyers’ Dynamic Radiology of the Abdomen: Normal and Pathologic Anatomy. New York, NY: Springer New York; 2011:69–107.
31.
Saboo SS, Krajewski, KM, Oregan, KN, Giardino, A, Brown, JR, Ramaiya, N, & Jagannathan, JP. Spleen in haematological malignancies: Spectrum of imaging findings. The British Journal of Radiology. 2012;85(1009), 81-92.CrossRef
32.
Ahmann DL, Kiely JM, Harrison EGJ, Payne WS. Malignant Lymphoma of the Spleen. A review of 49 cases in which the diagnosis was made at splenectomy. Cancer. 1966;19:461–469.
33.
Montemayor P, Caggiano V. Primary Hemangiosarcoma of the Spleen Associated with Leukocytosis and Abnormal Spleen Scan. Int Surg. 1980;65(4):369–373.PubMed
34.
Karakas HM, Demir M, Ozyilmaz F, Cakir B. Primary angiosarcoma of the spleen: In vivo and in vitro MRI findings. Clin Imaging. 2001;25(3):192-196.CrossRef
35.
36.
Abbott RM, Levy, AD, Aguilera, NS, Gorospe, L, & Thompson, WM. Primary Vascular Neoplasms of the Spleen: Radiologic-Pathologic Correlation. RadioGraphics. 2004;24(4), 1137-1163.CrossRef
37.
Compérat E, Bardier-Dupas A, Camparo P, Capron F, Charlotte F. Splenic metastases: Clinicopathologic presentation, differential diagnosis, and pathogenesis. Arch Pathol Lab Med. 2007;131(6):965-969.CrossRef
38.
Levy AD, Shaw, JC. & Sobin, LH. Secondary Tumors and Tumorlike Lesions of the Peritoneal Cavity: Imaging Features with Pathologic Correlation. RadioGraphics. 2009;29(2), 347-373.CrossRef
39.
Mortelé KJ, Mergo PJ, Taylor HM, Ernst MD, Ros PR. Splenic and perisplenic involvement in acute pancreatitis: Determination of prevalence and morphologic helical CT features. J Comput Assist Tomogr. 2001;25(1):50-54.CrossRef
40.
Iliescu L, Orban C, Ioanitescu S, Toma L. Splenic abscess due to acute pyelonephritis. BMJ Case Rep. 2014;2:1-2.
41.
Lee DH, Smith DS. Splenic Abscess After Acute Pyelonephritis. Am J Med. 2017;130(3):e109-e110.CrossRef
42.
Morioka H, Yanagisawa N, Suganuma A, Imamura A, Ajisawa A. Bilateral emphysematous pyelonephritis with a splenic abscess. Intern Med. 2013;52(1):147-150.CrossRef
43.
Ielpo B, Mazzetti C, Venditti D, Buonomo O, Petrella G. A case of metachronous splenic metastasis from renal cell carcinoma after 14 years. Int J Surg. 2010;8(5):353-355.CrossRef
44.
Liu Z, Chow MWL, Lua AHC, Tan RBW. Rare isolated synchronous splenic metastasis in a patient with type II papillary renal cell carcinoma. AME Case Reports. 2018;2:9-9.CrossRef
45.
Costantini M, Tuderti G, Minisola F, et al. Metachronous Isolated Splenic Metastasis in a Young Patient With Renal Cell Carcinoma: Case Report and Literature Review. Urology. 2019;127:13-18.CrossRef
46.
Kugel V, Dekel Y, Konichezky M, Baniel, J, Livne, PM, & Koren, R. Unusual Splenic Metastasis from Renal Cell Carcinoma. A Case Report and Review of the Literature. Pathology - Research and Practice. 2003;199(11), 739–743.
Metadata
Title
A review of anatomy, pathology, and disease spread in the perisplenic region
Authors
Ashley Etchison
Christine O. Menias
Dhakshina M. Ganeshan
Nikita Consul
Ayman Nada
Akram M. Shaaban
Ayman H. Gaballah
Sanaz Javadi
Khaled M. Elsayes
Publication date
01-02-2021
Publisher
Springer US
Keyword
Pathology
Published in
Abdominal Radiology / Issue 2/2021
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-020-02736-8

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