My Assisgnment

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Submitted By mshort21984
Words 703
Pages 3
1. The splenic and portal veins can be demonstrated by the injection of radio-opaque dye into the spleen. This has been done in dogs with exteriorised or subcutaneous spleens, and in humans with enlarged spleens by direct injection.

2. The injected dye leaves the spleen quickly and in large amounts, and demonstrates the sizes of the splenic and portal veins.

3. In the absence of portal obstruction a filling defect is present where the superior mesenteric flow meets the splenic.

4. In the presence of portal obstruction the site of obstruction is indicated. In addition, collateral veins are filled with dye, the portal vein is dilated and a reflux of dye may occur into the superior mesenteric vein. Changes in the direction of blood flow in the portal tributaries may be shown.

Any patient who has splenomegaly of unknown origin is a candidate for diagnostic splenic puncture, and theoretically any candidate for diagnostic splenic puncture is a candidate for splenography. The term splenography, used by the authors for convenience, is by no means widely accepted, commonly used synonyms being splenic portography, splenoportography, transabdominal splenic portal venography, and intrasplenic portal venography.
A special equipment tray assembled specifically for this procedure contains sterile drapes, sponges, appropriate needles for local anesthesia and splenic puncture, syringes, and a flexible rubber connector. With the patient in place on the radiographic apparatus, a field in the region of the 9th and 10th left interspaces laterally is suitably prepared and draped. Local anesthesia is obtained, and a puncture is made with a 4-inch No. 18 needle, of a type commonly used in this institution for diagnostic splenic puncture. The needle is inserted through the lateral aspect of the 9th or 10th interspace in such a manner that its point passes cephalad and…...

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