CHAPTER XXV. 

 THE SPLEEN. 



ANATOMY CLINICAL EXAMINATION. 



RELATIONS. DISEASE. 



LANDMARKS. OPERATIONS. 



The spleen averages about five inches in length, four 

 in width, and one and a half in thickness, and is situated 

 deeply in the left hypochondrium between the fundus of 

 the stomach, the under surface of the diaphragm and the 

 upper end of the left flexure of the colon. When harden- 

 ed in situ it presents three surfaces, external, internal and 

 basal, and two borders, anterior and posterior. It is 

 obliquely placed in the abdomen, both from above, down- 

 wards and outwards, and from above, downwards and 

 forwards, and is so situated, that its long axis is parallel 

 to the direction of the lower ribs. 



Relations. The external surface looking up- 

 wards, backwards and to the left, is in relation with the 

 under surface of the diaphragm. The internal sur- 

 face is divided into two areas by a vertical ridge, 

 in front of which is the hilum for the transmission 

 of the vessels, etc., to and from the spleen. The anterior 

 of the two areas is in relation with the fundus of the stom- 

 ach and the tail of the pancreas, whereas, the posterior 

 touches the left kidney and the left suprarenal capsule. 

 The basal surface is triangular in shape, forms the lower 

 end of the spleen, and is in contact with the phreno-colic 

 ligament and the splenic flexure of the colon. The an- 

 terior border is thin and sharp and is marked by three or 

 four notches, while the posterior border is blunt and dips 

 in between the diaphragm and the kidney. The spleen is 

 supported by certain peritoneal ligaments, the principal 



