In attempting to get an idea of the frequency of enlarged spleen in children, it was necessary to keep in mind that the spleen is subject to change in size as well as in position and that a great many things may contribute to this. Some of these causes are transitory and even appear to be physiologic; for instance, the swelling of the spleen that follows a heavy meal or a transfusion of blood.1 Again, the spleen may be pushed about and may give the impression of enlargement, as by a narrowed thorax in rickets or by fluid in the pleura, or it may be displaced upward and escape detection because of distention of the abdomen by gas or by fluid; it may be impossible to feel the spleen because of muscle rigidity or the resistance of the child. However, an interesting fact is that enlargement of the spleen
BLEYER A. ENLARGEMENT OF THE SPLEEN IN CHILDREN. Am J Dis Child. 1927;34(2):176–179. doi:10.1001/archpedi.1927.04130200020003
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