The use of transabdominal ultrasonography in the diagnosis and management of splenic lesions in three horses

Evaluating the equine spleen

“…The Case Report by Alsop et al (2007) demonstrates how useful ultrasonography can be in the diagnosis and monitoring of treatment of splenic diseases in the horse. The spleen is very well-suited to transabdominal ultrasonography, since it normally lies immediately adjacent to the left body wall in the mid and caudal abdomen, and usually medial to the liver in the left cranial abdomen.…”

“…Although ultrasonography is extremely useful in diagnosing splenic abnormalities, the precise nature of lesions identified by ultrasonography may be difficult to determine, as demonstrated by the cases described by Alsop et al (2007). Biopsy of the spleen can be undertaken using a percutaneous cutting biopsy needle (with ultrasound guidance where appropriate) or via laparoscopy.…”

“…Laparoscopic examination, therefore, permits a more complete abdominal examination, and should be considered as an adjunct to ultrasonography. Laparoscopy was performed in Case 2 described by Alsop et al (2007), and this aided the collection of biopsies from the spleen, but no mention is made of visible abnormalities in other abdominal organs. It would be surprising for mycobacterial infection to be confined to the spleen without involvement of other intraabdominal tissues.…”

“…Laparoscopic ultrasonography combines the two imaging modalities, and permits video-guided ultrasound examination of targeted organs/lesions within the abdomen. Laparoscopic guided biopsy or needle aspiration, when the lesion can be viewed, will reduce the risks of bleeding, intestinal puncture and exudate leakage that are mentioned by Alsop et al (2007). If bleeding or exudate leakage does occur it will be seen and can be addressed appropriately at the time.…”

“…The major goals of clinical medicine are to establish a diagnosis, prognosis and treatment. As highlighted by Alsop et al (2007), the practitioner can encounter horses that have clinical signs and laboratory values that are diagnostically 'nondefinitive'. Veterinarians, based on their knowledge and experience, educate owners as to the cost/benefit and risk/benefit of various diagnostic and therapeutic options.…”