We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |


Jacob K. Berman, M.D.; E. Dale Habegger, M.D.; Don C. Fields, M.D.; Warren L. Kilmer, M.D.
JAMA. 1957;165(12):1537-1541. doi:10.1001/jama.1957.02980300017005.
Text Size: A A A
Published online


The preoperative differential diagnosis of injuries to the abdominal viscera depends on detailed correlation of physical and laboratory findings at the time of admission with the findings of the surgeon at laparotomy. Analysis of 338 such cases showed that the most distinct effect was the leukocytosis that followed rupture of the liver or spleen by blunt trauma. The average of 23,890 white blood cells per cubic millimeter seen in liver injuries and 19,050 in blunt trauma to the spleen was higher than that caused by gunshot or stab wounds to these viscera and also higher than that following trauma of any sort to other abdominal viscera. The data on systolic blood pressure and hemoglobin concentration, though valuable in evaluating the condition of the patient, did not lead to comparable generalizations. A total leukocyte count of 15,000 or more per cubic millimeter justifies the suspicion of ruptured liver or spleen if other findings are compatible with that diagnosis.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.