DEPARTMENT OF SURGERY

3RD YEAR
Chairman: Dr. Jan Michael V. Yap
Vice Chairman: Dr. Manfred Tabilog
Regular Faculty: Dr. Jon Francis Co, Dr. Dale Ross Duran, Dr. Dr. Nielsen Flordeliz, Dr. Michael Alan Simporios,
Dr. Eloise Ana Suan, Dr. Jessa Christine Surban-Vergara, Dr. Carlos Antonio Go, Dr. Aufel Marie Acero

MODULE 9: PANCREAS AND SPLEEN

DAY 4
- Brian Griffin, a typical rebellious 18-year-old, male, leaves his house unannounced to spend his
afternoon skateboarding with his friends. While attempting to perform a nollie hardflip to a bluntslide
from a height of 2 meters, he lands his skateboard awkwardly on the pavement, throwing him forward
with him landing on his left flank onto the curb of the street. Brian immediately grimaces in pain, and,
after letting out a scream, falls unconscious in front of his friends. He is immediately rushed to the
nearest emergency room in the Gorordo area where he is met by the Surgical Resident on duty, Dr.
Spencer Glenn Tipdust.

Brian’s vital signs are unstable and immediate resuscitation with a warmed crystalloid is started
followed by blood transfusion of a type-specific whole blood.

Upon waking, Brian notices overhead lights shining over his eyes, and the calming voice of the
anesthesiologist telling him everything is going to be okay.

Brian is lying in the operating table about to be scheduled for an emergency exploration and
splenectomy.

Question:
1. Discuss briefly the anatomy and embryology of the spleen:
a. What are the main vessels that supply the spleen?
b. What are the major suspensory ligaments of the spleen?
i. Which of these ligaments contain blood supply to the spleen?
c. What are the main components of the spleen?
i. Red pulp
ii. White pulp

2. What are the main functions of the spleen

a. Spleen physiology
3. What imaging tests are helpful in the diagnosis and assessment of the spleen and its many conditions?

4. What are the different indications for splenectomy and what are their expected outcomes?
a. In various benign diseases
b. In various malignant disease
c. In various miscellaneous conditions

5. What is the treatment for platelet disorders such as Idiopathic Thrombocytopenic Purpura?
a. What is its first-line treatment?
b. What is its second-line treatment?

6. What is Overwhelming Post-splenectomy Infection?

a. How is this complication treated?