In The Lancet there is an account of three recent
excisions of the spleen for injury at St. Thomas Hospital in
London, and it is added that they are among the first of this
kind in Great Britain.
Abnormalities of Size of the Spleen.--The spleen may be extremely
small. Storck mentions a spleen that barely weighed an ounce;
Schenck speaks of one in the last century that weighed as much as
20 pounds. Frank describes a spleen that weighed 16 pounds; there
is another record of one weighing 15 pounds. Elliot mentions a
spleen weighing 11 pounds; Burrows one, 11 pounds; Blasius, four
pounds; Osiander, nine pounds; Blanchard, 31 pounds; Richardson,
3 1/2 pounds; and Hare, 93 ounces.
The thoracic duct, although so much protected by its anatomical
position, under exceptional circumstances has been ruptured or
wounded. Kirchner has collected 17 cases of this nature, two of
which were due to contusions of the chest, one each to a
puncture, a cut, and a shot-wound, and three to erosion from
suppuration. In the remaining cases the account fails to assign a
definite cause. Chylothorax, or chylous ascites, is generally a
result of this injury. Krabbel mentions a patient who was run
over by an empty coal car, and who died on the fifth day from
suffocation due to an effusion into the right pleural cavity.
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