XXVI. Diseases of the Spleen.
So intimately is the function of the spleen related to the character and construction of the blood that disorders of that fluid are apt to involve the spleen, and actual disease of the organ does not occur except as the result of disease elsewhere. In no case does an original or primary attack occur in this organ.
Splenic Hyperemia.
Acute Hyperemia, sometimes known as acute splenic tumor, may precede or accompany the onset of acute splenitis, as in inflammation of other organs. An acute engorgement of the organ occurs as the result of a direct injury, as from a blow or a wound, or as a vicarious condition from suppression of the menstruation, or from other conditions which induce acute inflammation.
Passive Hyperemia is a disease of slower development, and occurs during the course of and as a result of chronic malaria, or it follows those conditions which are induced in the liver by any influence, either mechanical or circulatory, which impede or obstruct the portal circulation.
The symptoms are a sensation of fulness and weight in the left hypochondrium. The organ is considerably enlarged, often greatly so, and tender; rarely is there much pain. When the hyperemia is intense, as occurs after an injury or from abscess, a rupture of the capsule of the organ may occur. It may also follow typhoid fever, or it may occur during severe intermittent fever, and from an epileptic seizure. The symptoms are those of intestinal perforation and concealed hemorrhage. There is shock, rapid prostration and collapse, with feeble and failing heart action, cold sweats and syncope.
In splenic engorgement the organ can be plainly felt through the abdominal walls. It is found to extend downward and forward, as outlined by dulness on percussion. In some cases the outlines of the organ can be plainly seen through the abdominal wall.
Treatment:—The treatment will be the same as that suggested for acute splenitis.
