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Splenosis is the autotransplantation of splenic tissue, usually after traumatic rupture of spleen. Reports of splenosis pleurae are rare. Of the six cases reported so far, there is only one (Shaw and Shafi, 1937) trabeculae could be seen. Microscopic examination (fig 2) showed that red pulp predominated over the white. The white pulp consisted of clusters of lymphocytes with no germinal centres.

during an influenza epidemic. We have shown, however, that subunit vaccine is well tolerated by asthmatic patients and is immunogenic. for Egyptian (schistosomal) splenomegaly. In addition, he was found to have iron deficiency anaemia (haemoglobin concentration 11-2 g/l). After nasogastric intubation and fluid replacement (including 1 unit of blood) laparotomy was performed through a paramedian incision. There were some 3 litres of haemorrhagic ascites and a gangrenous segment of jejunum 76 cm long. There was a clear cut line of demarcation between the viable and non-viable bowel but no constriction ring and nothing to suggest previous entrapment of the loop. Thrombosis was observed in the small mesenteric veins draining the affected segment, but the major mesenteric and splenic veins were all patent. The liver and colon seemed normal.After resection of the gangrenous small bowel with end to end anastomosis the patient recovered and was discharged home 12 days later. Histological examination showed thrombosis of medium sized mesenteric veins and arteries, which contained numerous ova ofS mansoni type. There was coagulative'necrosis of the resected bowel but no evidence of arteritis or any other underlying cause for vascular occlusion. CommentThe pathological lesions of schistosomiasis result from the deposition of a large number oflive ova-in the serosal and submucosal layers of the intestine. Enzymatic digestion of the tissues provokes a chronic inflammatory response, characterised by ulceration and thickening of the mucosa, which may accumulate to form polyps.23 Symptoms include abdominal colic, diarrhoea, rectal passage of blood and mucus, and allergy like reactions, such as fever and urticaria. Though children may develop acute dysentery, emergency presentation is unusual in adults. We are not aware ofany reports of acute mesenteric ischaemia as a complication of schistosomiasis. Nevertheless, our patient showed no evidence of any other condition known to be associated with mesenteric ischaemia secondary to occlusive disease of the small vessels, in particular atherosclerosis, Buerger's disease, embolism, and autoimmune disease. Vasculitis was excluded by the histological findings, and there was no relevant drug history.4'5 The finding of many parasitic ova in the thrombosis in the mesenteric vessels supports our diagnosis.We thank Professor R C N Williamson and Mr M I Aldoori, Department of Surgery, Bristol Royal Infirmary, for reading the manuscript. Bronchoconstrictor properties of preservatives in ipratropium bromide (Atrovent) nebuliser solutionThe original formulation of ipratropium bromide nebuliser solution (Atrovent) caused paradoxical and severe bronchoconstriction in some asthmatic patients. We showed that this response was due to hypotonicity of the original solution,' and as a consequence it was reformulated to render it isotonic. Recently, however, bronchoconstriction after inhalation ofisotonic ipratropium bromide solution has also been reported. As well as containing the active ingredient ipr...