European Journal of Cardiovascular Medicine

Spleen is an encapsulated complex mass of vascular and lymphatic tissue located in the left hypochondrium and partly in the epigastric region of the abdomen. It is covered by the periotenum and related to the fundus of the stomach, left kidney and the diaphragm¹. It plays important roles in immunological defence, metabolism and maintenance of circulating blood elements¹. The spleen lies just beneath the left dome of diaphragm close to 9^th, 10^th, and 11^th ribs⁴. Spleen is an intraperitoneal, wedge shaped organ, dark purplish in color and friable due to high vascularity. The shape of the spleen is also variable and mostly determined by

Its relations to neighbouring structures during development; it often appears as a slightly curved wedge. The size and weight of the spleen varies with age and sex under different conditions ^1. The average adult weight is dependent on volume of blood and weighs between 70 to 150 g and in vivo ranges from 150 to 350 g¹. The adult spleen is usually 9–14 cm long, 6–8 cm wide and 3–5 cm thick. Direct traumas to the overlying ribs can rupture the spleen and can cause bleeding in the peritoneal cavity^3.It is mainly concerned with phagocytosis, maintenance of erythrocytes and immune response¹.

The external features of spleen are as follows

Two poles: Superior pole faces the vertebral column and inferior pole is longer lies adjacent to splenic flexure and phrenicocolic ligament¹Inferior pole is at risk of injury during surgical procedures on stomach, pancreas, kidney and suprarenals¹.

1. Three borders: Superior border is notched, inferior border is rounded and an intermediate border ².
2. Surfaces: Diaphragmatic surface is smooth and convex visceral surface is concave and marked by impressions ².
3. Hilum: Cleft in the hilum between stomach and left kidney for the passage of splenic vessels and ligaments².

The spleen develops in dorsal mesogastrium as discrete condensations of mesenchymal cells fuses to form spleen³. The spleen is nodular in fetus, but the lobules normally disappear before birth. The notches in the superior border of the adult spleen are remnants of the grooves that separate fetal lobules¹⁰.Spleen gains its importance due to its functions during infections and for surgeons during surgeries of left kidney, tail of pancreas, stomach and colon. It is an important structure for radiologists due to its notches, clefts and shapes⁵ .The notches, clefts and weight varies with individuals who are of importance to surgeons and radiologists that have intrigued me to do this study. Two types of spleen compact type and distributed type are described⁹.The surgeon should be able to describe the type by palpating the borders and notches ⁹.In compact type the upper border is smooth and rounded. The quantitative study of size and shape has become a crucial tool to understand the anatomy and function of several organs, including the spleen. Precise studies of the morphometric parameters of the spleen can provide valuable insights into its development, function, and potential pathology. .In addition, spleen-related conditions including lymphoma and splenomegaly can be diagnosed and monitored with the help of morphometric analysis. The aim of this study is to find morphological variations of spleen in relation to its notches in different borders, clefts in different borders, its weight, length, breadth and thickness. Our objectives are to:

1. Establish a comprehensive dataset of spleen morphometric parameters.
2. Provide a foundation for future studies on spleen morphology and its clinical applications

By elucidating the morphometric characteristics of the spleen, this study will contribute to a better understanding of its anatomy, function, and potential pathology, ultimately informing the diagnosis and treatment of spleen-related disorders.

This present study was done on 40 formalin fixed human adult cadaveric spleens of both the sexes obtained from cadavers during routine dissection for undergraduate students in

PESIMSR, Kuppam A.P. Cadavers with any pathologic abnormality and with signs of decomposition were excluded in this study. As per the given instructions of Cunningham’s manual of practical anatomy the greater curvature of the stomach was pulled to expose the spleen and the ligaments gastrosplenic and lienorenal which are attached to the hilum had been cut along with the blood vessels⁷. The spleen was removed and stored in 10 percent formalin. The spleens were carefully examined to determine the presence of splenic notches, clefts, weight, length, breadth and thickness. All observations were tabulated and analyzed with their variations compared with available literature.

Table 1: Compartive morphometric analysis of spleen

In this study out of 40 cadaveric spleens 26 spleens were observed to have the notch on their superior borders. There were no notches in 5 spleens. 2 spleens were having notch in the superior border along with the cleft in there inferior border. 1 spleen had notch only in the intermediate border. Only one spleen was found to have notch only in the inferior border.

The weights of the 40 spleens were recorded and it was ranging from 20.39g to 328.96g.

The length, breadth and thickness of the 40 spleens were carefully measured by using vernier caliper and the results were tabulated. One spleen with the least weight was 24.6g and the largest one was measuring 328.96g. The length of the spleens was ranging from 6.4cm to 12.1cm. The breadth of the spleens was ranging from 3.7cm to 9.5cm. The thickness of the spleen was ranging from 1.3cm to 5.5cm. These observations were tabulated and compared with the available literature

Table 2

Figure 1: Spleens with no notches

Figure 2                                                            Figure 3

Figure 2: Spleens with notches in the superior border and cleft in the inferior border

Figure 3: spleens with notches in superior and inferior border

Figure 4: The spleen with notch in the intermediate border

Table 3

The spleen with the least weight was 20.39g and the spleen with the maximum weight was 328.96g.

The average weight of the spleen was 133.50g.

Figure 5: Spleen with the least weight                       Figure 6: measuring the length of the spleen between 2 ends

Table 4

The spleen with the maximum length was 12.1 cm and the spleen with the minimum length was 6.4cm. The average length of the spleen was 9.275cm

Table 5

The spleen with the minimum breadth was 3.7 cm and the spleen with the maximum breadth was 9.5 cm. The average breadth of the spleen was cc

Table 6

The spleen with the maximum thickness was 5.5 cm and the spleen with the minimum thickness was 1.3 cm

The average thickness of the spleen was 3.225cm

This study aimed to investigate the morphometric analysis of the spleen in relation to its notches and measurements in adult human cadaveric spleens of both sexes. The results of this study provide valuable insights into the morphological characteristics of the spleen, which can be useful in various fields of medicine, including anatomy, surgery, and radiology. The present study observed a significant variation in the morphometric parameters of the spleen, including its length, breadth, thickness, and weight. The mean length, breadth, and thickness of the spleen were found to be 9.275cm, 6.51cm, and 3.225cm, 133.50g. 70% of spleen of this study was having notches in the superior border which corresponds with other studies. Spleen with no notches were 17.5 % which is little more than other studies. One spleen had notch in the intermediate border that is 2.5% which has not been reported in the available studies. The spleen with the least weight was 2.5% weighing 20.39 g was not reported so far. Additionally, the correlation between spleen size and body weight can be used to develop more accurate diagnostic criteria for spleen related disorders. These results are in line with earlier research that found notable differences in the spleen's morphometric properties. The study also observed a significant variation in the presence and distribution of notches and clefts in the spleen borders. In conclusion, this study provides a comprehensive morphometric analysis of the spleen in relation to its notches and measurements in adult human cadaveric spleens of both sexes. The results of this study have important implications for various fields of medicine and can be used as a reference guide for future studies. The study demonstrates the value of morphometric analysis in advancing our understanding of the spleen anatomy and its clinical significance.

1. Standring S: Gray’s Anatomy: The Anatomical Basis of the Clinical Practice, 41^st Edinburg: Elseiver Churcill Livingstone, 2006; 1188.
2. Snell’s; Clinical anatomy By Regions South Asian Edition , Page number234-236
3. Clinical Anatomy ( A Problem Solving Approach), Neeta V Kulkarni 3^rd Edition, 556-559
4. A study of splenic notches in human cadavers and its clinical implications, Dept of Anatomy, Sri Siddhartha Medical College Tumkur, Karnataka India
5. Adult cadaveric spleen, Manisha S More, Manoj D Togale, Shilpa Bhimalli
6. MORPHOLOGICAL STUDY OF SPLEEN AND VRIATIONS IN SOUTH INDIAN POPULATION, M.Chelladurai, J.Sujitha Jacinth, T.Ramamani, G.Subbulakshmi.
7. Cunningham’s Manual of Pactical Anatomy Vol 2, 15^th Edition G.J.Romanes, page number 117.
8. LeeMcGregor,s synopsis of Surgical anatomy Twelfth edition Page number 106- 107
9. A Textbook of Human Anatomy by T.S . Ranganathan 3 rd Edition Page number 281 -284
10. Morphometric study of human adult cadaveric spleen Manisha S More¹, Manoj D Togale^2*, Shilpa Bhimalli³