One young talented doctor laterthe famous writer, was signed by his first literary experiments as follows:. "The Man Without a spleen" Alias turned out funny: Who is - is unknown, without which this man - is also unclear. After all, in those days, when practiced by Anton Chekhov, spleen baffled representatives from all schools of thought in medicine. Perhaps this mysterious organ interested Chekhov doctor.
What role does the spleen in the bodyman, until recently it was not clear. According to my student memories, its function medvuza teachers spoke very carefully and only alleged. Why? The fact is that, as shown by the medical practice, the body could well do without this authority. There are situations when it had to be removed. For example, if as a result of trauma stomach or spleen wounds began to bleed heavily, it was removed, and the people continued to live quietly without any noticeable complications.
With paired organs in such a situation, everything is clear. After the removal of one of the "twin" with the function of the second handle. This applies to the kidneys, the lungs. But how can you remove the authority, if there is one? You can not, for example, not replacing, remove the heart or liver. And why can the spleen?
So what is the role of the spleen in organizmeLishthe middle of the last century there was a suspicion that the older red blood cells break down in the spleen. But it seemed strange: why take the body to a body under the cemetery of red blood cells? After the body - the system is very economical. It remained unclear. And only when the rapidly began to develop immunology, find out the true role of the spleen in the body.
Spleen - unpaired organ. It is small (the average length of 8-15 cm, width - 9.6 cm). Located in the abdomen, in the left upper quadrant, symmetrically liver. Splenic artery, from which the body gets the blood off directly from the most important artery of the body - the aorta, and already from the spleen by venous blood vessels leaving the liver. Such an arrangement on the main lines of blood speaks of communication function of the spleen with blood composition. It is now known that the spleen performs immunological, filtration and hematopoietic function. Participates in metabolism - in particular, iron and proteins. As you can see, the role of the spleen is not too small. But while it is not a vital organ. So whether the effects are possible and what are the diseases of the blood for diseases or removal of spleen?
The entire spleen is riddled with connectivestrands. Between them is the very fabric of the spleen - pulp (pulp). The vessels of the pulp just crowding blood cells - red blood cells, lymphocytes, macrophages. Mainly consists of spleen red pulp, in which there are specks of white pulp in the form of spherical aggregates.
The function of red pulp - the destruction of obsoleteerythrocytes and other blood cells, such as outdated platelets. Furthermore, it deposits and blood iron, sending them into the blood stream as required. Involved in the synthesis of bile pigments. This is wrong. Of the victims, grown old or defective red blood cell hemoglobin is released and processed blood cells, macrophages (big eaters) spleen with iron release and the formation of precursors of bile pigments.
The white pulp of the spleen - a branch of the immune system. In the white pulp of the periphery of each "bead" ripen T cells received from another immune organ - thymus. In the center sections of white pulp lymphocytes proliferate in and begin to produce antibodies which enter the spleen of blood. It is interesting that in the process of fetal development in the spleen of the child multiply and other blood cells - red blood cells. Then the process (erythropoiesis) in the spleen dies.
Diseases of spleen
Can a lien be sick? Proper spleen diseases do not occur often. So I just list some of them.
Myocardial spleen. It turns out that it is not only in the heart. There are also focal necrosis of spleen tissue thrombosis of splenic blood vessels. In diagnosing this condition very difficult.
It happens occasionally and tuberculosis celezenki.
Spleen and injuries - wounds, ruptures, which is fraught with severe bleeding (in these cases could not be avoided emergency surgery).
But more often the spleen is affected secondarily, whenvarious infections. The fact that it performs a filter function and - a delay microbes. But it is not always cope with them. The pathological process of the spleen is involved in such infections as infectious mononucleosis (a viral disease that affects the blood cells), viral hepatitis, malaria, brucellosis, typhoid and others. In sepsis (blood infection) is even an abscess of the spleen. In all these cases (except for an abscess, which requires surgery) treat major infectious diseases. A spleen is then recovered herself.
- If the injury occurs as a result of injury orsplenic rupture, there is severe bleeding. It is dangerous to life. A sewing soft spleen tissue is almost impossible - it cut the thread, do not hold.
- The second case - it's hereditary oracquired diseases accompanied by a decrease in the number of platelets (fermentopathy hereditary, autoimmune diseases, and others.). Thus there is a tendency to subcutaneous hemorrhage. Formed huge numerous bruises at the slightest injury or even without it. In severe cases, bleeding tendency becomes dangerous. In situations where conservative treatment fails, resort to the removal of the spleen (splenectomy). If you remove the spleen, platelets will live longer (although less complete), and their number will increase in the blood. This strong bruising will occur less frequently. From them will prevent accumulated in the blood platelets.
- The spleen is removed and its abscesses, but it occurs much less frequently.
Since the spleen, as I have already said,the filter body, then it delayed tumor cells that carry the bloodstream. Therefore, if the tumor struck a nearby organ (eg, the left kidney), the spleen is removed prophylactically. It also happens that the metastasis formation in the spleen - in this case, be sure to remove it.
Life after surgery
In principle, spleen physicians creates fewer problems than other organs. But it really does not change when you remove it? What are the consequences of the disease that menyaetsya blood?
It raised the number of blood platelets. If this occurs in diseases with thrombocytopenia (decrease in platelets in the blood), then it is good. Thus postoperative platelet count sometimes rapidly rises and then decreases slightly. In other patients, the platelet count is increased only to a maximum of 5-6 month after the operation. But it noted that even when the platelet count is not increased by a blood test formally, still bleeding slows and decreases. But if the spleen was removed after the injury and normal until the platelet count exceeds the norm, it's bad. You may experience thrombosis. So long period after surgery is necessary to monitor the dynamics of the state of the blood coagulation system.
After splenectomy is somewhat reducedresistance to infections. Especially to the pneumococcus. Therefore, at present before such operations sometimes patients are vaccinated against pneumococcal infection. And after the operation it is necessary to try not to take cold. And to live, of course, possible. Without losing quality of life.