Anatomy clinical correlates Quiz: Ace Your Exams

A 25-year-old woman presents to the emergency department with a three-day history of epistaxis and rash on her lower extremities. She frequently participates in fighting tournaments.The patient was initially diagnosed with idiopathic thrombocytopenic purpura over a year ago after developing irregular menstrual bleeding. The following year, the patient developed frequent mucosal bleeding after mild trauma. The patient has received multiple medications, including intravenous immunoglobulin and prednisone. The patient’s response to treatment has been transient with platelet counts dropping below 10,000/mm3. Vitals are within normal limits. Physical examination shows diffuse epistaxis and multiple erythematous, brown macules noted on her lower extremities that do not blanch with pressure. Workup for chronic autoimmune disorder and viral infections is negative. Bone marrow biopsy shows normocellular marrow with slightly increased megakaryocytes. The patient is scheduled for elective splenectomy. The patient is at increased risk of injury to which of the following structures during this procedure?