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Four patients with splenic masses were operated upon and found to have epidermoid cysts of the spleen, a rare lesion comprising less than 10% of benign, nonparasitic splenic cysts. The patients were young and had vague, non-specific symptoms which were related to the size of the slowly enlarging splenic mass. Three patients had palpable masses. Contrast gastrointestinal studies and intravenous urography will help exclude mass lesions of the gastrointestinal or genitourinary tract. Sonar scan may confirm the cystic nature of the lesion and localize it to the spleen. A review of 42,327 autopsy records at the Los Angeles County--University of Southern California Medical Center revealed 32 benign splenic cysts found incidentally at autopsy. Hemorrhage, infection, rupture, and rarely, malignant change are complications of splenic cysts. Splenectomy is recommended to eliminate the symptoms produced by the cyst and prevent the potential complications.

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Since various types of surgical portal-systemic venous anastomoses are employed in the treatment of portal hypertension, it is of interest to know the effect of these operations on hepatic hemodynamics.There is general agreement that the major hepatic hemodynamic disturbance in cirrhosis is an increase in vascular resistance in the liver, together with an increase in portal venous pressure, and a variable, moderate reduction in hepatic venous blood flow. The fact that wedged hepatic vein pressure is increased to near portal vein pressure level in most patients suggests that the major portion of the increased vascular resistance is on the hepatic venous side of the sinusoid. Portal hypertension, then, can be regarded as a compensatory mechanism for the increased vascular resistance caused by the cirrhotic liver. The possible contribution of increased splanchnic or hepatic arterial inflow to portal hypertension cannot be ignored, although if this were a major factor we would expect to find consistent increases in hepatic venous flow in cirrhosis. Creation of a surgical portal-systemic venous anastomosis would be expected to lower portal pressure and reduce portal inflow into the liver. The effect upon hepatic venous flow would be dependent upon the degree of reduction in portal venous inflow that existed prior to surgery, together with any adjustments that might take place in hepatic arterial flow.Bradley, Smythe, Fitzpatrick and Blakemore, using the standard sulfobromophthalein (BSP) method to measure liver blood flow, found an average fall of 22 per cent in five patients after *