MORPHOLOGICAL ANALYSIS OF VARIATIONS OF SPLEEN

Address for Correspondence: Dr. Ganesh Trimbak Waghmode, Navodaya Medical College, Raichur, Karnatka, India. Pin 584101 E-Mail: gw1726@gmail.com Background: Spleen is encapsulated vascular and lymphoid organ. Clinically study of spleen is significant in immunological and haematological disorders. Context and purpose of the study is to study morphological variations of spleen and to compare them with previous studies. Materials and Methods: Present study carried out with 74 spleens at the Department of Anatomy, Navodaya Medical College, Raichur, Karnatka, India, furthermore we observed for various morphological features. Results: Out of 74 spleens 11 spleens were triangular, 41 spleens were tetrahedral and 22 spleens were wedge shaped. The mean length was 11cm , the mean breadth was 7.1cm, the mean width was 5.45cm, the mean weight was 141.77gms and the mean volume was 140.45cm3 . Conclusion: 74 normal spleens were studied with shapes, lengths, breadths, widths, weights and volumes were analysed. Present study will help radiologists, physicians and surgeons in diagnosing disorders of spleen.

The spleen is not essential for life as removal of spleen does not leads to sudden death [5].Dimensions and functions of spleen were discovered in 20 th century [6].It may become haemopoietic in pathological conditions.It is situated between diaphragm and fundus of stomach in the left hypochondium and partly in the epigastrium.The spleen has two surfaces diaphragmatic and visceral [1].Spleen develops in dorsal mesogastrium.The process of formation of spleen occurs at several adjoining areas which fuse to form lobulated Spleen is secondary lymphoid organ as it is the site of maturation of lymphocyte and their activation and initiation of an immune response, spleen is organ of haemopoeisis before bonemarow development [1].The spleen is the grave yard of dead red blood cells as the spleen is the site of red blood cell destruction [2].The spleen has third highest blood perfusion rate [3].The spleen is called as melancholy as ancient Greece scientist thought that the spleen was the source of black bile [4].spleen Early lobulated character of the spleen disappears but notches at upper border remains [7].
Spleen has visceral and diaphragmatic surfaces, anterior and posterior extremities and inferior and superior borders [1].Accessory spleens may be present in 4.50% cases, in the form of roundish nodules at the hilum of the spleen [8].
Visceral surface presents gastric, renal colic and pancreatic impressions Diaphragmatic surface is smooth and convex, directed upwards, backwards and to the left.Superior border separating the gastric impression from the diaphragmatic surface is thin, convex and presents one or two notches close to the lateral end.Inferior border separates the renal impression from diaphragmatic surface and extends obliquely coinciding with the lower border of the left 11 rib.
Posterior extremity or medial end is blunt and rounded, directed upwards backwards and medially towards vertebral column.Anterior extremity or lateral end is broad and represented by a border, which extends between superior and inferior borders.It is directed downwards, forwards and to the left Anterior basal angle is the junction of the superior border and lateral end and it represents the most forward projecting part of spleen.Posterior basal angle is the junction of the inferior border and lateral end of spleen [9].
Spleenomegaly is important diagnostic sign in malaria, kalaazar, inflammatory and degenerative disorders [10].In spleenomegaly, the anterior border, anterior part of diaphragmatic surface and notched superior border may become clearly palpable below the left costal margin [11].

MATERIALS AND METHODS
74 spleens collected from department of anatomy R.G.I.M.S. Srikakulam , NRI.I.M.S. Visakhapatnam and N.M.C. Raichur.Intact normal human cadaveric spleens were selected only 7 spleens from female cadaver were available.dissection was done with standard method of cadaveric dissection 9 measurement were calculated by Vernier calliper and electric weighing machine.Length = greatest distance between two poles Breadth = greatest distance between two points at superior and inferior Borders Width = greatest width Volume [12] = (0.36 X Length X Breadth X Width) + 28 Different shapes were observed.The obtained data analysed and compared with previous studies.

RESULTS
In all 74 spleens two poles anterior and posterior, two borders superior and inferior and two surfaces diaphragmatic and visceral were observed.Gastric, renal, colic and pancreatic impressions were seen at the visceral surfaces of all 74 spleens.Out of 74 spleens 11 spleens were triangular shaped, 41 spleens were tetrahedral shaped and 22 spleens were wedge shaped oval and irregular shaped spleens were not seen in present study.In Table 1 in present study weight of spleen varied between 56gms.-344gm.65 spleens (87.83%) varied between 100gms.to 200gms.
Only 2 spleens varied between 250gms to 350gms.Five spleens are having less weight varied between 50gms to 99gms.Average weight of spleen was 141.77gms.In Table 3 in present study breadth of spleens varied between 38mm to 92mm 72 spleens varied between 41mm to 79mm.Only seven spleens varied between breadth 70mm to 89mm.Eight spleens have less breadth varied between 30mm to 49mm.Average breadth was 59.58mm.In Table 4 in present study width of spleen varied between 11mm to 74mm .71 spleens were varied between 31mm to 69mm.Average width was 49.78mmAccording to Sir Alfred Cuschier spleen varies in shape and three morphological types are desired [13].According to studies of Prassopolous spleen shapes are crecentric, rhomboid and triangular [14].
In present study tetrahedral shaped spleens were more (55.4%)than previous studies.Triangular (14.86%) and wedge shaped (29.74%) were less than previous studies.
Oval and irregular shaped spleens were not found In present study, those shapes were present in previous studies.According to Malawatkar the dimensions of the spleen are 1.4cm x3.5cm x 7cm [21] Herald Ellis discovered odd numbers related to dimensions of the spleen 1inches thickness, 3 inches width, 5 inches length, 7 ounces weight, related to 9 th to 11 th According to Sir Alfred Cushier the normal dimensions of the spleen are 3cm x 9cm x 13 cm [22].DISCUSSION Table 7: Comparison of shapes of spleen between previous studies and present study.
studies.Previous studies on volume of spleen were based on ultrasonogrphy image of spleen, computed tomography image of spleen and Magnetic resonance imaging image of spleen.In present study morphometric volume of spleen is considered.Volume of spleen in present study was varied between 55.57cm3 to 363.77cm3 and average volume was 140.45cm3.In present study includes shape, number of notches, length, width, thickness, weight and volume of the spleen.Morphometric Volume of spleen is most important factor in diagnosis of various disorders of spleen, which was not considered by previous studies.Morphometric analysis in present study will be helpful for surgeons, and physicians in diagnosis and treatment of different disorders of spleen CONCLUSION Conflicts of Interests: None

Table 1 :
Weights of spleen in present study.
In Table 2 in present study length of spleens varied between 72mm to 137mm 62 spleens their lengths varied between 82mm to 118mm.Only four spleen varied between lengths 120mm to 139mm .Eight spleens have less length varied between 70mm to 79mm Average length was 97.89mm.

Table 2 :
Lengths of spleens in present study.

Table 3 :
Breadth of spleens in present study.

Table 4 :
Widths of spleen in present study.
In Table5in present study notches of spleens varied between 0 to 3 notches.57 spleens have only one notch .Four spleen were present without notch.Two notches were present in 12 spleens.Only one spleen was present with three notches.Ganesh Trimbak Waghmode et al.MORPHOLOGICAL ANALYSIS OF VARIATIONS OF SPLEEN.

Table 5 :
Number of notches of spleen in present study.In Table6in present study volume of spleen were measured in unit cubic centimetre.volume of spleen were varied between 55.57cm 3 to 363.77cm 3 .Only seven spleens were present with largest volume varied between volume 200cm 3 to 400cm 3 .15 spleens were having less volume varied between volume 50cm 3 to to 99cm 3 .Average volume was 140.45cm 3

Table 6 :
volumes of spleen in present study.

Table 8 :
Comparison of lengths, breadths, widths, weights and volumes between previous studies and present study.
Socioeconomic status, feeding habits, geographical conditions and genetic factors are different in western countries and India that is why values in present study were slightly lower than previous studies.Morphometric volume of spleen was not considered by previous