Five cases of occult or 'spontaneous' rupture of the spleen are described. Pathological examination of the spleen showed changes of infectious mononucleosis in 2 cases, Hodgkin's disease in 1, amyloidosis in 1 and in the remaining spleen no underlying disease process was seen. All 5 cases survived, and evidence from the literature suggests that this may have been in some measure due to the fact that prompt surgical treatment followed a correct preoperative diagnosis. The importance of awareness of the condition, radiological investigation and peritoneal lavage in reaching the correct diagnostic conclusion is discussed.

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Experience with the use of streptokinase in the treatment of iliofemoral venous thrombosis is described. Streptokinase in a dose sufficient to induce systemic controlled defibrination was administered via an indwelling cannula which was used for repeated phlebography during the course of lysis and for several days afterwards. Of 40 patients treated, 10 had complete clearance and 24 partial clearance of the thrombus with the establishment of an iliofemoral channel. In 5 patients lysis did not occur and in 1 it was followed by early rethrombosis.

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