PREVALENCE OF SPLENIC VARIANTS IN A SOUTH INDIAN POPULATION: A CROSS-SECTIONAL STUDY USING CT ABDOMEN IMAGING AT SAVEETHA MEDICAL COLLEGE, CHENNAI

Abstract

This cross-sectional study assesses the prevalence of various splenic variants in patients who underwent CT abdomen imaging over the past five years at Saveetha Medical College, Chennai, India. A total of 30,000 CT abdomen records from January 2019 to January 2024 were evaluated to identify splenic variants, including splenunculus, bilobed spleen, polysplenia, and asplenia, and their clinical implications were discussed in relation to the existing literature.

Introduction

The spleen plays a critical role in the human immune system and blood filtration. Variations in splenic anatomy, such as splenunculus, bilobed spleen, polysplenia, and asplenia, can have significant clinical implications, including challenges in abdominal surgeries, susceptibility to infections, and diagnostic ambiguities. This study aims to determine the prevalence of splenic variants in a South Indian population, compare these findings with national and international prevalences, and discuss their clinical significance.

Materials And Methods

This retrospective cross-sectional study analyzed 30,000 CT abdomen scans from patients at Saveetha Medical College, Chennai, conducted between January 2019 and January 2024. The study identified splenic variants and categorized them into splenunculus, bilobed spleen, polysplenia, and asplenia. The inclusion criteria were all patients who underwent CT abdomen imaging for various clinical indications. Exclusion criteria included poor-quality images and incomplete medical records. This study adheres to the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Results

Out of 30,000 CT abdomen images analyzed, splenic variants were identified in 269 (0.9%) patients. Splenunculus was the most common variant, found in 263 patients (0.88%), of which 260 were congenital, and 3 were post-surgical following high-grade splenic injuries due to motor vehicle accidents. A bilobed spleen was identified in 3 (0.01%) patients, polysplenia in 2 (0.007%) patients associated with heterotaxy syndrome and left isomerism, and asplenia in 1 (0.003%) patient, showing a congenital absence of the spleen along with a horseshoe kidney.

Discussion

The prevalence of splenic variants in this study is comparable to reported national and international figures, where splenunculus prevalence varies from 0.2% to 2%, and polysplenia and asplenia are rare. The study's findings align with literature suggesting that splenic variants, while uncommon, have significant clinical implications, including potential confusion during imaging analyses, implications for immunological function, and considerations during surgical procedures.

A review of the literature indicates a wide range of prevalence rates for these anomalies across different populations, reflecting the study's findings within expected parameters. The clinical significance of these findings lies in their potential to alter surgical approaches, impact immunological status, and necessitate tailored clinical management strategies.

Conclusion

This study highlights the prevalence of splenic variants in a South Indian population, with findings consistent with global data. Understanding the prevalence and clinical implications of these variants is crucial for diagnostic, surgical, and management strategies in patients with splenic anomalies.