A case of traumatic rupture of an accessory spleen.

Case Report T.M., an 8-year-old boy, was admitted to Alder Hey Children's Hospital on July 17, 1961, with a three-day history of central abdominal pain, accompanied by some nausea and vomiting. On the night before admission he slipped in the bathroom and hurt the lower part of his left chest. This injury did not seem to disturb him much, though, in reply to leading questions, he did say that the abdominal pain had slightly increased during the night. There was no history of pain referred to the left shoulder. On examination he did not look ill or exsanguinated. His temperature was 990 F. (37°C.); pulse 135 per minute, but ofgood volume; blood pressure 1 10,X80 mm. Hg. There was no bruising or tenderness over the site of trauma, and examination of the heart and lungs did not reveal any abnormality. The abdomen looked slightly distended, and there was localized tenderness in the right iliac fossa. Bowel sounds were present, though infrequent. Rectal examination revealed no tenderness, though there was suggestion of slight fullness in the pouch of Douglas. A diagnosis of appendicitis with peritonitis was made and laparotomy was carried out on the day of admission.