256 Anatomy Applied to Medicine and Smgery. 



treme friability of its tissues. Symptoms of collapse have 

 occurred during the operation from a twisting of the ped- 

 icle, and the common cause of death after splenectomy is 

 hemorrhage, frequently the result of ligating the pedicle 

 while there is a strain on it, so that a small vessel might 

 retract from under the ligature, and secondary hemor- 

 rhage occur. A number of methods have been devised and 

 applied by different operators to avoid subsequent hemor- 

 rhage. Greig Smith states, that success or failure in 

 this operation depends on the treatment of the pedicle. 

 He advises separate ligation of each vessel while it is in 

 a state of relaxation so as to avoid subsequent retraction, 

 and then, as an extra precaution, he surrounds the whole 

 pedicle with a single ligature. Splenopexy, or fixation of 

 a wandering spleen, may be attempted to avoid the neces- 

 sity of splenectomy. Rydygier, in 1893, introduced this 

 operation, making a pocket of the parietal peritoneum for 

 the purpose of receiving the spleen. Sykoff recommends 

 the surrounding of the organ with sterilized catgut, the 

 free ends of which are fixed to the parietes. 



