c l i n i c a l f o l i o s : n a r r a t i v e





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Splenomegaly from Polycythemia: 13

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The splenic artery was identified at the superior border of the distal tail of the pancreas (see abdominal vascular relationships, frames 5 and 6.) The distal location was chosen to preserve the blood supply to the pancreas via the great and dorsal pancreatic arteries (see Whipple, frame 9.)    

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Splenomegaly from Polycythemia: 14

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The splenic artery was carefully isolated.     

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Splenomegaly from Polycythemia: 15

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The splenic artery was doubly ligated in continuity with 2-0 silk. Preliminary ligation of the splenic artery decreases the risk of bleeding when manipulating the spleen and hilum, allows the spleen to shrink for easier manipulation, and provides an autotransfusion as the spleen empties through the intact vein.    

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This page was last modified on 2/11/2005.