Splenectomy for splenomegaly / by J.A. Nixon.
- Nixon, John Alexander, 1874-1951.
- Date:
- 1913
Licence: In copyright
Credit: Splenectomy for splenomegaly / by J.A. Nixon. 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.
4/9
![pain was very severe and lasted all the morning. The next morning the same thing happened, and it recurred every other day up to the time of admission. Violent exercise or jolting in a tramcar would bring on the pain. Sometimes she felt sick with pain, but had never actually vomited. There had been no appearance of blood in the urine, nor any trouble with micturi- tion.” The patient was a well-grown girl, pale, anaemic and sallow-complexioned, with numerous flecks of pigment or large freckles about the skin. No stigmata of congenital syphilis. Abdomen.—No visible abnormality. On jialpation a con- siderable area of resistance was felt in the left hypochondrium, caused bj- a smooth, somewhat conve.x swelling which moved on respiration, e.xtended beneath the ribs above and had a well- defined margin interiorly ; no definite edge could be felt and no notch made out. The tumour was dull on jiercussion, and the dulness extended into the sjfleen area. No band of colon resonance could be found passing over the front of the tumour. The maximum size of the swelling was about four fingers’ breadth below the ribs. Cutaneous hyperersl/iesia.—The skin was exceedingly sensitive to a light touch or firm jiressure over the whole left side of the alxlomen and the whole of the left leg, where a jiinch, which was scarcely felt on the right leg, caused exquisite pain. There was also on the abdomen a well-defined zone of tactile hyjHTjesthesia and hyjx-ralgesia, corresponding with the distribution of the tenth dorsal nerve from the spinal processes to the mid-line in front, with the usual spots of tenderness to deej) Jiressure. ]'ertchral column.—There was some ajiparent rigidity of the sjiine in the lower dorsal region, with prominence of the spinous jirocesses. But no jiarticular sjiine was unduly prominent or deviated. Percussion of the sjiine and jarring of the heels caused jiain to lie felt radiating round the left side of the body down towards the groin. On liending backwards or forwards there was alwaj’s an inclination of the body towards the right side. Examination of the abdomen and sjiine caused considerable pain, which lasted for two or three hours afterwards. .All reflexes were normal, and no other abnormality of the nervous system was discovered. Heart and lungs.—Health}^ in all resjiects. Lymphatic glands.—No enlarged glands. Urine.—No abnormal appearance or quantity, sp. gr. varied between 1010-1022. Once or twice a faint trace of albumen was jiresent, but nothing else abnormal. No deposit. No casts. Temperature.—Never raised above normal.](https://iiif.wellcomecollection.org/image/b22460561_0006.jp2/full/800%2C/0/default.jpg)
