RUPTURE OF THE SPLEEN: A NEW ROENTGEN SIGN

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Abstract
Splenic rupture is a grave clinical condition which demands prompt treatment. Since the clinical and roentgenologic diagnosis of this entity is often inaccurate, we have described a new procedure consisting of an anteroposterior roentgenogram of the stomach after a barium meal, with the aid of a horizontal roentgen-ray beam, with the patient lying on his left side, referred to as "the left decubitus roentgenogram." In cases of splenic rupture, the distance between the greater curvature of the stomach, especially in the cardiac region and the abdominal wall, is increased. Over 30 patients were examined by this procedure. In 5 of them it helped us to diagnose splenic rupture, later proved by laparotomy. Two other cases we believe to be examples of subclinical occult splenic rupture, which spontaneously regressed. The usefulness of the left decubitus procedure and its pitfalls are discussed, as is the differential diagnosis between splenic rupture and splenomegaly. The conclusions drawn are provisional and more experience is needed to assess its value in diagnosis.

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