Clinico-radiological study of the pancreatic tail in relation to the splenic hilum

Abstract

Introduction: Splenectomy is one of the most commonly performed surgical procedures worldwide. The splenic hilum is closely related to adjacent organs like the tail of the pancreas, stomach, splenic flexure of colon, and left kidney. One of the morbid complications of splenectomy is injury to the tail of pancreas. The objective of this study was to assess the anatomical details of the pancreatic tail with respect to the splenic hilum by assessing patient’s abdominal computed tomography (CT) imaging. Methods: A total of 150 patients’ abdominal CT imaging was taken for evaluation in this study. The distance between the pancreatic tail and the splenic hilum was measured. The level of location of the pancreatic tail in relation to the splenic hilum was also noted for each patient. Results: The pancreatic tail was inferior to the level of the splenic hilum in 59.3 percent (n =89) of the patients, superior to the level of the splenic hilum in 2.0 percent (n =3) of the patients, and at the level of the hilum in 38.7 percent (n = 58) of the patients. The mean distance from the pancreatic tail to the splenic hilum was 13.1 ± 5.2 mm. Conclusion: Abdominal CT imaging will provide a road map regarding the location of the pancreatic tail and the distance between the pancreatic tail and the splenic hilum. With the preoperative CT imaging details and efficient surgical dissection as close as possible to the splenic hilum, the potential injury to the pancreatic tail can be prevented. Keywords: splenectomy; pancreatic tail injury; splenic hilum; pancreatic fistula