D. Ignjatovic • R. Bergamaschi () Bergen University School of Medicine 6800 Førde, Norway e-mail: Roberto.Bergamaschi@medfa.uib.no arteries and vascular zones (p<0.05). The rationale for splenic lobe/segment dearterialization without resection is found in the presence of intrasplenic anastomoses. Key words Anatomy • Spleen injury • Spleen salvage • Left hemicolectomy • Bleeding Introduction Salvage of an injured healthy spleen is desirable. Neverthe- less, many surgeons prefer splenectomy basically because alternative procedures at hand are risky and demanding [1–3]. Dearterialization of the inferior lobe of the spleen has been performed in the treatment of thalassemia major [4] and for operative trauma to the inferior splenic pole during left hemicolectomy [5]. Interestingly, necrosis of the dearterial- ized parenchyma did not occur in these patients, and anato- my textbooks do not explain why [6]. This discrepancy and the fact that we have previously per- formed this procedure [5] prompted the present post-mortem study. The aim was to provide a rationale for spleen preser- vation in inferior pole injury during left hemicolectomy by ligation of the inferior polar artery or of the inferior terminal branch of the splenic artery without spleen resection. Materials and methods A total of 102 consecutive fresh (<24 hours) autopsy specimens from patients (53 men) with a mean age of 54 years (range, 26–83) were obtained from January to June 1997. Five cadavers were exluded from the study because of macroscopic pathological changes of the spleen from metastatic disease (n=2), splenomegalia due to liver cirrhosis (n=1), echinococcus cyst (n=1), and trauma (n=1). The spleen and tail of the pancreas were removed en bloc through a midline incision of the anterior abdominal wall. The gas- Tech Coloproctol (2002) 6:93–96 © Springer-Verlag 2002 D. Ignjatovic • R. Bergamaschi Anatomical rationale for spleen salvage by lobe/segment dearterialization in inferior pole spleen injury during left hemicolectomy: a post-mortem study Received: 20 March 2002 / Accepted: 17 May 2002 ORIGINAL ARTICLE Abstract The aim of this study was to determine the rationale for spleen salvage by lobe/segment dearterialization without resection for inferior pole injury during left hemicolectomy. One hundred and two consecutive human cadavers were dis- sected. Corrosion cast and post-mortem arteriography with computerized planimetry were employed. Lobe/segment size, artery diameter and length and anastomoses between arteries were measured. The mean inferior terminal splenic artery had a significantly smaller diameter than the superior (2.8 vs. 3.4 mm, p<0.01). An inferior polar artery was found in 22.5% of the specimens (mean diameter, 1.9 mm; mean length, 33 mm). The inferior lobe and inferior polar segment comprised 41.3% and 12.6% of the spleen, respectively. Anastomoses were detected in 34 of 102 spleens (3% extra- parenchymal, 88% intraparenchymal, 9% combined). The mean diameter and length of intrasplenic anastomoses were 0.3 mm and 20 mm, respectively. In conclusion, there was a positive correlation between diameters of lobar/segmental