Splenectomy in tropical splenomegaly.

Erythrocyte Pooling and Sequestration in Enlarged Spleens: Estimations of Splenic Erythrocyte and Fiasma Volume in Splenomegalic Patients

“…Erythrocytes labelled with Na2 51Cr O4 have been used for studying erythrocyte kinetics in splenomegaly. Their mean survival has been found to be reduced, in accordance with increased sequestration in the enlarged spleen (Toghill 1964, Pryor 1967. Simultaneous registration of the radioactivity in the circulating blood and the surface activity over the spleen immediately after infusion of labelled erythrocytes has afforded information about the erythrocyte circulation in the spleen (Harris et a1 1958, Toghill 1964.…”

“…Thereby the increase in plasma volume contributes to reducing the peripheral haemoglobin concentration, viz. 'haemodilution anaemia', and regarding the erythrocyte pooling in the enlarged spleen the total red cell mass may be underestimated when judged from the venous haematocrit (Pryor 1967, Blendis et al 1969, Bowdler 1970. The increase in plasma volume seems to grow more marked with increasing splenomegaly (Blendis et al 1969), without the cause of the increased volume being known.…”

The coeliac axis and its branches in splenomegaly and liver disease.

“…The increased size of the spleen, which in cirrhosis and tropical splenomegaly is due partly to venous engorgement and partly to reticulo-enthothelial cell hyperplasia (McMichael, 1934;Moschcowitz, 1948;Pryor, 1967), is accompanied by an increased total blood supply, although flow per 100 g tissue is often reduced (Williams et al, , 1968). An increase in blood flow cannot occur without dilatation of the entire splenic arterial tree (Pouseille's law) and in keeping with this are the studies of Manenti and Williams (1966), using injected spleen casts, which showed an increased number of peripheral arterioles of 100 mm diameter.…”

The Complete Spleen

“…before and after splenectomy, have been reported in patients with enlarged spleens associated with cryptogenic and tropical splenomegaly (McFadzean et aI., 1958b;Hamilton et aI., 1967;McFadzeanand Todd, 1967;Pryor, 1967b;Crane et aI., 1972), Gaucher's disease , primary splenic hyperplasia , myelo-and lymphoproliferative diseases, other blood dyscrasias and congestive splenomegaly Tables 4 and 5).…”

“…In many conditions associated with splenomegaly, the bone marrow is unable to adapt by increasing cell output sufficiently to maintain normal peripheral blood values. When red blood cell output is insufficient to maintain normal packed cell volume in the circulation, the volume deficit is compensated by expansion of the plasma volume, resulting in dilutional anemia Hess et aI., 1971;Hess et aI., 1976;Pryor, 1967;Blendis et aI., 1970). 9.5.2.…”