On the Occurrence of Palpable Spleens in Healthy Newborn Babies and Healthy Infants.

Abstract

The author gives an account of experiences in further investigations into the occurrence of palpable spleens in healthy new-born infants and in healthy infants below the age of six months. The results were as follows: 1 ) 1060 clinically healthy new-born infants, with birth weights of at least 2 900 g were each examined once during the first week of life to establish the occurrence of palpable spleens. The frequency of positive palpation findings shows an evenly rising tendency up to and including the third day of life, after which it steadily declines step by step. The results agree very well, even when statistically analysed, with a series published earlier by the present author, in which all the children were subjected to daily examinations of the spleen during the first week of life. Both the investigations series thus show that the frequency of positive spleen palpation findings exhibits a statistically verified maximum on the third day after birth. The average frequency of positive palpation findings in the new series is 32.1 ± 1.4 %, the maximal frequency on the third day of life is 45.5 ± 4.0 %. 2 ) Healthy infants, above the new-born age, show a frequency of positive spleen palpation findings which in the case of children younger than three months is 17.7 ± 3.6 % and for children between three and six months is 14.9 ±4.4 %. The former series comprises 113 children, the latter 67. Statistically there is good agreement between the frequency of positive spleen palpation findings in healthy infants below the age of three months and that in children between three and six months of age. 3 ) There is a statistically verified difference between the average frequency of positive spleen palpation findings in healthy new-born infants, on the one hand, and in infants at ages between the new-born period and six months, on the other. Thus in healthy new-born infants a positive spleen palpation finding is considerably more usual than in other infants below the age of six months. 4 ) The author emphasizes the necessity of care and practice in spleen palpation on infant children. Further, the dynamic conditions which characterize the physiological enlargement of the spleen are emphasized. The enlarged spleen found in the case of pathological conditions in the new-born and in healthy infants is often more voluminous and of firmer consistency and therefore easier to observe than in the clinically healthy in the same age-group. Nevertheless in infants which are entirely free from any signs of disease there is not infrequently a relatively large and firm palpable spleen. This is true particularly of the new-born period.