Chronic splenic anaemia and Banti's disease / by H.D. Rolleston.

  • Rolleston, Humphry Davy, 1862-1944.
Date:
1914
Catalogue details

Licence: In copyright

Credit: Chronic splenic anaemia and Banti's disease / by H.D. Rolleston. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    anaemia in the chronic splenomegaly, and in the acquired cases by the presence of anaemia. In the hereditary and congenital cases of haemolytic jaundice, the subjects—for they are not patients—often do not present any signs or symptoms except acholuric jaundice and splenomegaly, and their lives are not necessarily shortened thereby. The outlook is therefore very different from that in splenic anaemia, in which really persistent jaundice is so rare that its occurrence should lead to examina- tion of the red corpuscles for increased fragility. I do not know if splenic anaemia has ever been recognized in the subject of transposition of the viscera, but the diagnosis in such a case might be very difficult. Treatment.—Medical treatment consists in good hygienic conditions, the administration of iron and arsenic, and recently the intravenous injection of salvarsan, which has been stated to give good results. Exposure of the splenic region to X-rays has also been said to be followed by diminution in the size of the organ, but it has not been proved that the benefit is permanent. Splenectomy appears to be the only form of treatment of real value. Extensive adhesions may make the operation very difficult, and there is some risk of severe or fatal post- operative haemorrhage. The question of splenectomy in any given case is therefore an anxious problem; if left alone, the patient will eventually die, whereas operation will cure or kill at once. There are numerous statistics bearing on the results of splenectomy, but some impartially include cases of Banti’s disease, Gaucher’s disease, simple splenomegaly, and splenic anaemia, and therefore will not be quoted. Banti3 stated that splenectomy in the first stage of “ spleno- megaly with cirrhosis ” (which is splenic anaemia) was attended by a mortality of 12*5 per cent., and Rodman and Willard,37 though not dealing with the same cases, come to a similar conclusion. Mr. H. S. Souttar has suggested to me that the risks of laparotomy and splenectomy might be avoided and good results obtained by inserting a tube of radium, by means of a specially constructed trocar, directly through the abdominal wall into the substance of the spleen.