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Tropical Splenomegaly

by A. K. BASU, M.S. (Cal.), F.R.C.S. (Eng.), F.A.C.S., Director-Professor, Department of Surgery, Institute of Post Graduate Medical Education and Research, Calcutta; Hunterian Professor, Royal College of Surgeons of England; Examiner in Surgery, Royal College of Surgeons of England; and B. K. AIKAT, M.D. (Path.), D.C.P. (Lond.), Ph.D. (Lond.), Director-Professor, Department of Pathology and Bacteriology, Institute of Post Graduate Medical Education and Research, Calcutta. xii + 195 pages, illustrated. Butterworths, London. 1963. $10.00

In tropical regions splenomegaly is common and is not always the result of malarial hyperendemicity. Where malaria has been eradicated cases of splenomegaly still occur to puzzle the clinician. This work analyzes 190 patients suffering from "Tropical or Bengal Splenomegaly" in India. In only 6 cases was a protozoal infection found, in 1 case malaria and in 5, kala azar. In the remainder thrombocytopenic purpura was found in 5, thalassemia in 8 and liver disease or extrahepatic obstruction in 171. So, in Bengal at any rate the great majority of cases of splenomegaly are due to a well recognized cause, usually liver disease. In 81 cases portal hypertension was present. These cases were all fully investigated at operation by splenic venography and liver biopsy; many had splenectomy and shunt operations performed. In those with liver disease post-necrotic cirrhosis was found in the majority.Porto-caval shunt operations produced the most benefit as was to be expected where there was portal hypertension with extra hepatic obstruction.