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The spleen is a lymphoid organ situated in the upper and left part of abdomen between fundus of stomach and diaphragm. It lies mainly in left hypochondrium (lateral 2/3) and partly in epigastrium (medial 1/3). On an average spleen is 1 inch (2.5 cm) thick, 3 inches (7.5 cm) broad, 5 inches (12.5 cm) long and 7 ounces in weight. It is related to 9th to 11th ribs on left side. The spleen lies obliquely along the long axis of10thrib. Thus it is directed downwards, forwards and laterally, making an angle of about 45 degrees with horizontal plane. Spleen projects into greater sac.


Gross morphology

  1. Spleen has two ends (anterior or lateral and posterior or medial), three borders (superior, inferior and intermediate), two surfaces (visceral and diaphragmatic), two angles (anterobasal angle or posterobasal angle) and hilum.
  2. Anterior end is supported by Phrenicocolic ligament.
  3. Superior border is characteristically notched near its anterior end.
  4. Visceral surface is related to fundus of stomach (at gastric impression), left kidney (at renal impression), splenic flexure of colon (at colic impression) and tail of pancreas (at pancreatic impression). Its lower end is related to Phrenicocolic ligament. Diaphragmatic surface is related to the diaphragm.
  5. Spleen is surrounded by peritoneum and is suspended by following ligaments:
    1. Gastrosplenic ligament: - It connects the hilum of spleen to stomach (greater curvature). It contains short gastric vessels, associated lymphatics and sympathetic trunk.
    2. Linorenal ligament: - It connects spleen (hilum) to left kidney (anterior surface). It contains tail of pancreas, splenic vessels, pancreaticosplenic lymph nodes, lymphatics and sympathetic nerves.
    3. Phrenicocolic ligament: - It is not attached to spleen but supports its anterior end and prevents its downward displacement

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Blood supply and nerve supply

  1. Arterial supply to spleen is through splenic artery, largest branch of coeliac trunk.
  2. Venous drainage is through splenic vein which unites with superior mesenteric vein to form portal vein behind neck of pancreas.
  3. Nerve supply is through coeliac plexus, which is sympathetic supply of spleen.

Structure of splenic parenchyma


The spleen comprises many units of red pulp and white pulp, which are centred aroundcentral arterioles (smaller branches of splenic artery).

  1. White pulp: - The aggregations ofT and B lymphocytes around the arterioles form White pulps or Malpighian bodies. Arrangements of lymphoid tissue around the arteriole of each white pulp are as follows: - 'l-cells in the center as periarteriolar lymphatic sheaths (PALs), B-cells in the middle, and dendritic presenting cells at periphery. On antigen stimulation B-cells proliferate to form germinal center.
  2. Red pulp: - Red pulp contains large number of venous sinusoids draining into tributaries of splenic vein.
  3. Venous sinusoids are lined by endothelial stave cells which form incomplete layer and present intracellular slits between them through which blood can percholate.


  • The pancreas is a mixed gland, consisting of both exocrine and endocrine parts with very little connective tissue. It extends across the posterior abdominal wall from the concavity of duodenum to the hilum of spleen. It occupies the posterior part of epigastrium and left hypochondrium. From right to left the pancreas presents head, neck, body and tail.


  1. It is the broadest and thickest part that lies within the curve of duodenum. Its relations are:
    1. Anterior: First part of duodenums, transverse mesocolon, and peritoneum of jejunal loops.
    2. Posterior: IVC, terminal part of right renal vein, right crus of diaphragm, common bile duct.
      Superior: 1st part of duodenum, superior pancreaticoduodenal artery.
    3. Duodenal (right lateral):- 2nd part of duodenum, terminal bile duct, anastomosis between superior and inferior pancreaticoduodenal artery.
    4. Inferior: 3rd part of duodenum, inferior pancreaticoduodenal artery.
  2. Uncinate process is the part of head that extends to the left from its inferior and behind superior mesenteric vessels.
    Its relations are:
    1. Anterior: Superior mesenteric vein, occasionally superior mesenteric artery.
    2. Posterior: Aorta.
    3. Inferior: Upper surface of 3rd part of duodenum.


  1. Boundary between head and neck is marked anteriorly by groove for gastroduodenal artery and posteriorly by deep groove that contains union of superior mesenteric veinand splenic vein to form portal vein. Gastroduodenal and anterior superior pancreaticoduodenal arteries descend in front of pancreas at the junction of head and neck.
  2. Neck is related anteriorly to lesser sac and pylorus and posteriorly to origin of portal vein by union of SMA and splenic vein.



It is the longest portion of pancreas and has triangular cross section with three borders and three surfaces. Their
relations are:-

  1. Anterior border provides attachment to the root of transverse mesocolon. Superior border is related to coeliac trunk, hepatic artery and splenic artery. Inferior border is related to superior mesenteric vessels.
  2. Anterior surface is covered with peritoneum and is related to lesser sac and stomach. Posterior surface is devoid of peritoneum and is related to structures forming pancreatic bed: aorta with origin of superior mesenteric artery, left crus of diaphragm, left kidney, left suprarenal gland, left renal vessels and splenic vein. Inferior surface is covered by peritoneum and is related to duodenojejunal flexure, coils of jejunum and left colic flexure.


It is the narrowest portion of pancreas and lies in layers of Lienorenal ligament. It is related anteriorly to lesser sac, posteriorly inferomedial par of spleen and splenic vessels and below to left colic flexure. Tail of pancreas contains maximum number of Isletof Langerhens.



  1. Pancreas is developed from the two pancreatic buds.
    1. Dorsal pancreatic bud;-It is larger and most of the pancreas is derived from it i.e. most of the head, and whole neck, body & tail.
    2. Ventral pancreatic bud; - It is smaller and forms lower part of the head of pancreas including uncinate process.
  2. During 7thweek of development, the ventral and dorsal pancreatic buds fuse to form a single pancreatic mass.
  3. After the fusion of ventral and dorsal pancreatic buds, their ducts develop cross communications. Final duct system is formed as below -
    1. Main pancreatic duct (Duct of wirsung) is formed by the duct of ventral bud, distal part of duct of dorsal bud and an oblique communication between the two. The main pancreatic duct joins the bile duct to form hepatopancreatic ampulla that enters the 2nd part of duodenum at major duodenal papilla.
    2. Accessory pancreatic duct is formed by the proximal part of the duct of dorsal bud. It opens into 2nd part of duodenum at minor duodenal pupilla, 2 cm proximal (cranial) to major duodenal papilla.

Anomalies of pancreatic development may be;

  1. Annular pancreas; - Two components of the ventral bud fail to fuse and grow inopposite direction around the duodenum and meet the dorsal pancreatic duct.
  2. Pancreatic divisum (divided pancreas); - Ventral and dorsal buds fail to fuse with each other. It is the most common congenital anomaly ofpancrease.
  3. Inversion of pancreatic duct; - The main pancreatic duct is formed by the duct of dorsal bud, i.e. accessory duct is larger than the main duct and the main drainage of pancreas is through the minor duodenal papilla.
  4. Accessory pancreatic tissue;- May be found in –
    1. Wall of stomach, duodenum, jejunum or ileum.
    2. Meckel's diverticulum

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