SONO_ANATOMY: Pancreas and Spleen

T/F: the spleen is an interperitoneal structure

false; intraperitoneal

Where is the spleen located?

LUQ (Left hypochondrium), posterolateral to the stomach and tail of pancreas, posterior to the left colic flexure and anteriosuperior to the left kidney, anterior to the diaphragm

What supplies blood to the spleen?

splenic artery

How does the splenic artery course?

originates from celiac axis → courses along superoposterior margin of the pancreas → branches into two or more smaller arteries before entering the splenic hilum

Where does the splenic vein exit the spleen and travel?

hilum → courses posterior to the pancreas → anastomoses with the SMV at the Spleno-portal confluence to make the MPV

What are the average measurements of the spleen?

LONG- <13cm

TRANS- <5cm

AP- <7cm

*varies from person to person*

What view of the spleen is this?

LONG

What view of the spleen is this?

TRANS

What is the sonographic appearance of the spleen?

homogenous texture, smooth and medium gray

How is the texture of the spleen compared to the liver?

same echotexture or slightly less echogenic

What are some spleen sonographic applications?

Splenomegaly, splenic masses, trauma (contusion, laceration, hemorrhage)

What is the most common use of ultrasound of the spleen?

splenomegaly

T/F: splenic masses are common

false; rare

Label.

What does the pancreas consist of?

head, neck, body, tail, uncinate process

Where is the pancreas located?

across the midline in the epigastric region

Where does the tail of the pancreas extend to?

hilum of the spleen in the LUQ

What borders the pancreatic head just to the right of the midline?

duodenum

Where is the pancreatic head in relation to the IVC?

anterior

What is seen along the pancreatic head’s lateral margin?

GDA and CBD

What does the uncinate process curl around?

spleno-portal confluence

Where is the pancreatic neck in relation to the spleno-portal confluence?

anterior

Where is the pancreatic body in relation to the SMA and AO?

anterior

Where is the pancreatic tail in relation to the splenic vein?

anterior

Which part of the pancreas courses posteriorly towards the splenic hilum?

tail

What probe orientation are you in to scan the long-axis view of the pancreas?

TRANS

How are the heel and toe of the probe positioned when in TRANS view to scan the pancreas?

heel rotated slightly superior to see the tail

toe rotated slightly inferior to see the head

What are valuable landmarks when scanning the pancreas?

portal confluence and splenic vein

Label.

1. head

2. neck

3. body

4. tail

5. splenic vein

6. SMA

7. aorta

8. IVC

9. uncinate process

10. splenic confluence

What is the view of the pancreas sometimes referred to as?

racoon sign

Where is the pancreas measured?

anterior to posterior

What are the pancreas measurements?

Head- 2-3cm AP

Body- <2cm AP

Tail- <3cm AP

Duct- <2mm