Spleen Topography in an Upright Body Position

Abstract

The article covers the issues associated with determining spleen topography in living individuals in an up- right body position, as well as assessing the organ displacement during a deep breath and a change in shoulder position. A review of scientific literature revealed that all previous studies on the mechanism underlying spleen injuries are based on the generally accepted topographic location of the organ, which was determined using cadaveric material.Aim. To determine spleen topography (holotopy and skeletopy) in living individuals (both male and female) of different age groups, as well as to assess the organ displacement during a deep breath and when the shoulder position is changed.Material and methods. We conducted spleen ultrasound in adults of various age groups (males and females), 30 of whom were also examined in terms of its displacement when the shoulder position was changed. The position of the organ was noted during quiet and deep breathing, as well as when the shoulder position was changed; distance between the reference points was measured with the subsequent statistical analysis of the results.Results. It was found that the spleen of a quietly breathing person in an upright body position is projected from the lower edge of the 8th left rib to 10th left rib along axillary lines. During a deep breath, the organ is displaced downward, on average by 5.15 ± 1.48 cm (from 3 cm to 8 cm), and slightly, on average by 1.34 ± 1.25 cm, forward (from 1 cm to 4.5 cm). The longitudinal axis of the spleen is perpendicular to that of the rib. Changes in the position of the shoulder in the shoulder joint revealed no spleen displacement.Conclusion. The obtained data on the topographic location of the spleen will allow forensic medical experts to establish as objectively as possible the mechanism underlying spleen damage in terms of locating injurious exposure.

Methods of Ultrasound Spleen Morphometry

“…As a rule, the anterior border of the spleen is at the level of the medial axillary line, and its posterior border is at the level of the posterior axillary line. The longitudinal axis of the spleen is oriented perpendicularly to the long axis of the ribs 6 …”

“…The longitudinal axis of the spleen is oriented perpendicularly to the long axis of the ribs. 6 The spleen has diaphragmatic and visceral surfaces. The diaphragmatic surface is convex; it faces the diaphragm.…”