Chapter 17: Spleen

Chapter 17. Spleen

Splenectomy results in the loss of what immunologic protein?

A. Tuftsin

B. Immunoglobulin A

C. Membrane attack complex

D. C3 convertase

Answer: A. Tuftsin and properdin are immunologic proteins produced by the spleen. After splenectomy these 2 immunologic proteins are absent, increasing the susceptibility to encapsulated organisms.

What is the most common cause of splenic artery/vein thrombosis?

A. Portal hypertension

B. Pancreatitis

C. Pancreatic cancer

D. Factor V Leiden

E. Antiphospholipid syndrome

Answer: B. Pancreatitis is the most common cause of splenic artery/vein thrombosis.

What ligament contains the vascular supply to the spleen?

A. Splenocolic ligament

B. Gastrosplenic ligament

C. Phrenosplenic ligament

D. Splenorenal ligament

Answer: B. The gastrosplenic ligament contains the splenic artery/vein and short gastric arteries. In the setting of portal hypertension, the splenorenal ligament may contain a vascular supply.

What is the treatment for bleeding gastric varices in the setting of sinistral hypertension?

A. Gastrectomy

B. Transjugular intrahepatic portosystemic shunt

C. Mesocaval shunt

D. Splenectomy

E. Sclerotherapy

Answer: D. Splenectomy is the treatment for isolated gastric varices in the setting of sinistral hypertension.

Which of the following is not an indication to repair a splenic artery aneurysm?

A. Asymptomatic and size >2 cm

B. Pregnancy

C. Symptomatic and size = 1.5 cm

D. Presence of collagen vascular disease

Answer: D. Resection, with or without splenectomy, or embolization of a splenic artery aneurysm should be performed in pregnant patients, asymptomatic aneurysms >2 cm, and any symptomatic aneurysm.

When should a patient be vaccinated prior to elective splenectomy?

A. The day of surgery