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March 1960

Supradiaphragmatic Transposition of the Spleen for Portal Hypertension: An Experimental and Clinical Study

Author Affiliations

From the Department of Surgery and the Katz Sanders Laboratory for Experimental Surgery, Mount Sinai Hospital of Cleveland.

AMA Arch Surg. 1960;80(3):452-459. doi:10.1001/archsurg.1960.01290200096017

In 1955, two Finnish surgeons, Nylander and Turunen,1 reported that in three cases of cirrhosis of the liver with bleeding esophageal varices, they transposed the spleen above the diaphragm in order to create adhesions for a partial shunt to the systemic circulation.

In 1959, Turunen and Laitinen2 reported long-term results on these three patients. One patient (seven years after the operation which included ligation of esophageal varices) has had no further hemorrhage after the first year, has been fully active, and has a normal blood picture. The second case (operated on in 1953) has done fairly well, with no recurrence of hemorrhage. The third case (operated on in 1957) has had no recurrence of hemorrhage and is in good general condition.

In 1957, Turunen, Laitinen, Pasila, and Stjernvall,3 in dogs, experimentally transposed the spleen into the thoracic cavity. This was done in nine dogs with a survival