ENLAEGEMENT OF THE SPLEEN. 



297 



great vascularity of the spleen, due to the presence of numerous 

 thin-walled blood sinuses, explains the profuse and often fatal 

 haemorrhage which results from ruptures and penetrating 

 wounds. The anatomical relations of the organ sufficiently 

 explain why penetrating wounds are often complicated by 

 injuries to the pleura, lung, diaphragm, stomach, colon or 



superfic. area 



deep area of spleen 



mid. ax line 



lower border, lun 



splen. flex, colon 



kidney 



FIG. 41. THE POSITION AND RELATIONSHIPS OF THE SPLEEN. THE DEEP 



AND SUPERFICIAL AREAS OF ITS DIAPHRAGMATIC SURFACE ARE EXPOSED. 



(Hughes and Keith. ,) 



kidney. The greater sac of the peritoneum is of necessity 

 opened by such injuries. 



Enlargement of the spleen varies much in degree, and is met 

 with in very diverse conditions. If the increase in size is very 

 great, inspection may reveal the outline of part of the organ 

 below the left costal margin, extending in the direction of the 

 umbilicus. An enlarged spleen takes this direction by virtue of 

 its surroundings, for its convex surface lies against the resistant 



