Does the Spleen Have a Function in Digestion? Medical History, Phylogenetic and Embryological Development of the Splenogastric System

Abstract

Background: Before the spleen was discovered to be a lymphatic blood organ, it had for centuries been considered to be a digestive organ. Concepts of a regulative, secretory and resorptive function in the digestive system were based mainly on a postulated connection between the stomach and the spleen. Splenogastric vascular connections have recently been rediscovered by modern surgery. Summary: To test the hypothesis that the spleen has a digestive function, this article reviews the literature focusing on the interaction between the spleen and the stomach. We examine the historical medical view of the spleen and stomach system and the reasons why a digestive function was abandoned in the 17th and 18th centuries. We then review the rediscovery of the splenogastric system and the present-day state of knowledge (anatomical origin, variability, haemodynamics) and present it in terms of the phylogenetic and embryological development of the spleen and stomach system. Key Message: Splenogastric arteries and gastrosplenic veins form a portal system which directly connects the spleen and stomach parenchyma. Despite its mesodermal anlage, phylogenetically and embryologically the spleen is intimately interconnected with the entodermal stomach parenchyma but detaches from this in the course of development. Further study is required to establish whether the splenogastric system is merely an evolutive remnant or actually a part of a functioning spleen-stomach system as postulated in complementary and integrative medicine.