SPLEEN TOPOGRAPHY IN AN UPRIGHT BODY POSITION

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Abstract


The article covers the issues associated with determining spleen topography in living individuals in an up- right body position, as well as assessing the organ displacement during a deep breath and a change in shoulder position. A review of scientific literature revealed that all previous studies on the mechanism underlying spleen injuries are based on the generally accepted topographic location of the organ, which was determined using cadaveric material.

Aim. To determine spleen topography (holotopy and skeletopy) in living individuals (both male and female) of different age groups, as well as to assess the organ displacement during a deep breath and when the shoulder position is changed.

Material and methods. We conducted spleen ultrasound in adults of various age groups (males and females), 30 of whom were also examined in terms of its displacement when the shoulder position was changed. The position of the organ was noted during quiet and deep breathing, as well as when the shoulder position was changed; distance between the reference points was measured with the subsequent statistical analysis of the results.

Results. It was found that the spleen of a quietly breathing person in an upright body position is projected from the lower edge of the 8th left rib to 10th left rib along axillary lines. During a deep breath, the organ is displaced downward, on average by 5.15 ± 1.48 cm (from 3 cm to 8 cm), and slightly, on average by 1.34 ± 1.25 cm, forward (from 1 cm to 4.5 cm). The longitudinal axis of the spleen is perpendicular to that of the rib. Changes in the position of the shoulder in the shoulder joint revealed no spleen displacement.

Conclusion. The obtained data on the topographic location of the spleen will allow forensic medical experts to establish as objectively as possible the mechanism underlying spleen damage in terms of locating injurious exposure.


About the authors

I. A. Levandrovskaya

111th Main State Centre for Forensic Medical and Criminalistic Examinations

Author for correspondence.
Email: ilevandrovskaya@mail.ru

Russian Federation

Inna A. Levandrovskaya, Cand. Sci. (Med.), Forensic Medical Expert, Department of Forensic Medical Examination

Moscow

I. A. Aseeva

N. N. Burdenko Main Military Clinical Hospital

Email: asseevairina.goid@gmail.com

Russian Federation

Irina A. Aseeva, Cand. Sci. (Med.), Departmental Head, Department of Ultrasound Diagnostics, Centre for Diagnostic Radiology

Moscow

P. V. Pinchuk

111th Main State Centre for Forensic Medical and Criminalistic Examinations


Russian Federation

Pavel V. Pinchuk, Dr. Sci. (Med.), Assoc. Prof., Head of the 111th Main State Centre for Forensic Medical and Criminalistic Examinations; Chief Forensic Expert, Ministry of Defense of the Russian Federation, Honoured Health Care Worker of the Russian Federation

Moscow

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