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”In Englysche it is named a man’s Splene.

”In Englysche it is named a man’s Splene. A spongious substance lienge under the ribbes on the left side, and it doth make a man to bee mery and to laughe, Although melancholy resteth in the splene if there be impedimentes in it. If any man be splenitike let him use mery company,

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”In Englysche it is named a man’s Splene.

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  1. ”In Englysche it is named a man’s Splene. A spongious substance lienge under the ribbes on the left side, and it doth make a man to bee mery and to laughe, Although melancholy resteth in the splene if there be impedimentes in it. If any man be splenitike let him use mery company, Be joconde, and not to study upon any supernatural thynges.” -Andrew Boorde, The Breviarie of Helthe, 1547

  2. Hippocrates  Soft and fibrous • Aristotle  Anatomical posistion • Erasistratus  Symmetry with liver? • Galen  Stomach, liver, bile & digestion 460 B.C. ~1700 A.D.

  3. Splenectomy • 1549 • Napels • Adrian Zacarelli Woman, 24 years old, Splenomegaly with Malaria as probable cause. • Questioned; ovarian cyst?

  4. Splenectomy • 1590 • Traumatic spleen injury • During 2 centuries multiple splenectomies • First american splenectomy 1819 

  5. Splenectomy 1819, United States of America Case report: • Male, age 39 • Rape, stab wound, brought to emergency • Laceration of spleen • Removal of knife  protrusion of spleen • Partial splenectomy with ligation • Full recovery

  6. Splenectomy • 1866, England, Spencer Wells • Splenomegaly • Possible Leukemia • Operation went well • Patient died 1 week later, Infection • 1866, Thomas Bryant • Splenectomy for curing leukemia, many cases • 6 out of 50  88 %

  7. Splenectomy • End of 19th Cantury • >270 splenectomies • ~170 survivals • Standard in trauma of the spleen

  8. Splenectomy • First 20 years of 20th century • Splenectomies on: • Haemolytic anemia • Auto-immune thrombocytopenic purpura • Better physiological knowledge of the Spleen • 1911, Italy, Micheli • Curative splenectomy, severe haemolytic anemia • 1916, Kaznelson • Recovery from Thrombocytopenia following splenectomy

  9. O.P.S.I. = Overwhelming Postsplenectomy Infections First concise report in 1952 • Questioning the indications for splenectomy • Giving rise to surgical & non-surgical options Splenorrhaphy gained much support 1950-80

  10. Non-surgical • 1980s until now • Emergence of CT-scan • Decrease in surgical management of spleen injuries due to trauma

  11. And that’s pretty much it... Thank you for your attention!

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