Reports and Analyses and Descriptions of New Inventions in Medicine, Surgery, Dietetics, and the Allied Sciences

1878 BMJ (Clinical Research Edition)  
TIS . ' -AAW,.;CAL'--.' [*v. 6,I 18'7&' . His appetite was fairly good. -He *d, oecasipna1 diArrliee-a He had been under the care ofMrr Anthofiy Bell, who reqtistd me to see him, with a view to his -tmovlj mito the Infirmary AS uridergoing splenotomy. It is almost unnticessai" to say that perserering medical treatment had been:adopted. -The fortnidable nature ci the operation, and its attendant dangers, w*re fully placed before him; but he insisted upon it being done, and, after consultation
more » ... ter consultation with my collogues, medical and surgical, -the operation was performed on September 29th. Chloroform having been administered, an incision was made in the median line, extending about tiro inches on each side of the umbilicus. I then passed my hand round the spleen, and found it free from adhesions; the incision was then enlarged and the rectus muscle cut acrgss, the artery being held and secured before the transverse incision was carried through the peritoneum. The diaphragmatic and capsular connections were carefully torn through, ,and the spleen then easily turned out; it was held up while the vessels, which were considerably enlarged, were tied with three whipcord ligatures ; two large sponiges were then held round the pedicle, which was divided and the ,spleen removed. Much difficulty was now experienced in finding and securing one or two bleeding points, which seemed to be in the torn peritoneal connections, and were, of course, very deep. They were at limt1ecured, the belly carefully sponged out, and the wound closed by itcerupted sutures. The operation was conducted antiseptically, and occppied seventy minutes, t-he greater part of that time being spent in sec;uring the bleeding points. I had the kind assistance of my surgical colleagues and of the house-surgeons.
doi:10.1136/bmj.2.933.724 fatcat:daejv4nvznfshh4nhyrdmevwla