SPLENITIS. PERISPLENITIS.
Causes: extension from adjacent inflammations, penetrating bodies, contusions, lacerations, infections, over exertion, cold, damp, over feeding. Symptoms: those of primary disease, visible traumas, chill, fever, swelling, flatness of percussion sound, absence of crepitation, anorexia, vomiting, constipation, diarrhœa. Prognosis usually good. Treatment: castor oil, enemata, cold douche, electricity, phlebotomy, in infective cases quinine, salol, salicylates, iodides.
No accurate border line can be drawn between splenic hyperæmia and hypertrophy on the one hand and inflammation of the spleen on the other. It is, however, not difficult to assign to inflammatory action all cases that tend to suppuration and abscess. Also in perisplenitis with adhesions to adjacent parts like the liver, stomach, intestine, kidney or abdominal wall inflammation cannot be doubted.
Causes. Extension from the disease of adjacent parts—perihepatitis, perinephritis, peritonitis, enteritis—is a distinctly appreciable cause, as are also penetration of the spleen by foreign bodies, contusions, lacerations and infections of the organ. Cruzel, who claims an extensive acquaintance with the disease in working oxen, attributes many cases to violent exertions, overdriving, cold and damp weather, and an overstimulating alimentation. As inflammation may supervene on hyperæmia and hypertrophy we must accept the various causes of these conditions as factors in producing inflammation.
Symptoms. Most observations of inflammation of the spleen and its results have been made only post mortem, so that we must allow that the simple forms occur and undergo resolution without obvious symptoms. In the perisplenitis supervening on another disease also in infective cases there will be the antecedent symptoms of such primary diseases. In those resulting from traumatic injury, bruises, swellings or wounds, cutaneous or subcutaneous, there will often be suggestive features. In the more purely idiopathic cases symptoms are only shown when the lesions are extensive and acute. In oxen, Cruzel has noted the initial chill, followed by disturbance of the respiration, more or less hyperthermia, and a swelling of the left flank and hypochondrium in the absence of tympany of the rumen. The nature of this swelling is the most characteristic feature, as it gives a flat instead of a drumlike sound on percussion, and does not bulge outward and downward over the whole left side of the abdomen, pit on pressure, nor crepitate uniformly all over from fermentation, as in overloading of the stomach.
If abscess should form, chills and high febrile reaction are marked symptoms. In vomiting animals, anorexia, nausea, vomiting, constipation, and even diarrhœa may appear.
Prognosis. Unless in extreme cases and those due to traumatism or infection, the result of splenitis is usually favorable.
Treatment would consist in depletion from the portal system and spleen by rectal injections, and laxatives which like castor oil, will operate without extensive absorption. Cold water or ice applied to the left flank and induction currents of electricity may also be resorted to. General blood-letting is strongly advised by Cruzel, and Friedberger and Fröhner. In infective cases quinia, salicylates, salol, and the sulphites, or iodides would be indicated.