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he has forgotten the original and causative injury so that the spleen appears
to have ruptured spontaneously.

Patey50 reports the case of an apparently spontaneous rupture of a healthy normal
spleen in a healthy muscular man, aged 50, who suddenly and without apparent cause
experienced one evening acute pain in the epigastrium, which within a few minutes
became so severe that he had to stop work. After two days he was removed to hospital
where an abdominal operation was performed, and a rupture was found under the
capsule on the outer convex surface of the perfectly normal spleen communicating with
a similar rupture on its concave side round the posterior border. At the time he denied
having received any injury, but shortly after his discharge from the hospital he men-
tioned that at 10-30 a.m. on the day of the onset of his illness he was leaning over a
ledge in order to open his shop window, when he slipped and fell on to his left side
against the edge of the ledge. He had only slight discomfort and, thinking nothing of
the injury, dismissed it from his mind until the repeated questionings recalled the
incident. Undoubtedly, this forgotten trauma was the primary cause of the ruptured

Fig. 130.A. Rupture of spleen, fracture

of 9th left rib, and the weal mark.   The

husband hit the wife with a rolling pin

-     (Baku).   B. The ruptured spleen.

(From a photograph lent kindly by

Dr. H. S. Mehta.)


50.   Brit. Med. Jour., May 18, 1929, p
p. 652.

5; 'see also .A. W. Druitt, Lancet, Nov. 1, 1947,