Mesenteric embolism and thrombosis : a study of two hundred and fourteen cases / James Marsh Jackson, Charles Allen Porter, and William Carter Quinby.

  • Jackson, James Marsh.
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: Mesenteric embolism and thrombosis : a study of two hundred and fourteen cases / James Marsh Jackson, Charles Allen Porter, and William Carter Quinby. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    Ten days later had tearing sensations in abdomen, accom- panied by vomiting. Poor pulse, slight distension, peritoneal facies. On next day operation. One and one-half liters of ascitic fluid evacuated; a coil of jejunum blue colored. Death. Autopsy.—Slight agglutination of intestinal coils; 100 cm. of jejunum, beginning 90 cm. below duodenum, shows ulcerated mucous membrane. Mesentery thickened. Both superior and inferior mesenteric veins plugged by recent thrombi. Portal and splenic veins thrombosed. Spleen enlarged. PiCQUE and GrEgoire.—Man, 47 years. Mentally degener- ate. Had vomited for several weeks; then sudden increase of vomiting, distension of abdomen, with mass on left, which is dull and tender. No blood by rectum. Pulse 120; temperature 38 C. Urine slightly albuminous. Rectal examination negative. Laparotomy. Gangrene of intestine, but no stricture. Throm- bo-phlebitic process of superior mesenteric vein, extending into portal. PiCQufi and Gregoire.—Man, 49 years. Four days' story of obstipation which followed a diarrhea. Pain in epigastrium and vomiting. Abdomen not distended, but resistant. Liver dullness not increased. Temperature 38.8 C; pulse 118. Heart and lungs negative. Urine albuminous, small in amount. Laparotomy. Jejunum black with thickened mesentery. Celi- otomy. Death in twelve hours. Nothing definite found. Pieper.—Man, 38 years. For seventeen days acute articular rheumatism. On the eleventh day endocarditis. Twenty-four hours before death, profuse vomiting and bloody, foul-smelling stools, followed by colicky pains in abdomen. Pain not local- ized. Subnormal temperature. Death. Autopsy.—Peritonitis. Hemorrhagic infarct of spleen. In the superior mesenteric artery an adherent, fibrous clot, filling the main trunk and a branch of the ascending duodenal artery. Small intestine and ascending colon infarcted. Mucosa swollen, dark red, with numerous capillary extravasations. Venous hyperemia. Hemorrhages in mesentery. Glands infiltrated. Fluid blood within intestine. Pilliet.—Woman, 70 years. Sudden death. Abdomen dis- tended. Autopsy.—About 60 cm. of small intestine is dark bluish- red. Mucosa of altered portion gangrenous and of an opaque, brown color. Corresponding veins filled with red, partly dis- integrated thrombi. Small arteries not dilated. Pilliet.—Man, 72 years. Varicose veins in the legs. One day ago, while chopping wood, was seized with severe pain in the lower abdomen, accompanied by nausea and vomiting. Abdomen began to increase in size; very tender on pressure. No movement of bowels. Vomiting of coffee ground material. Death on the same day. Autopsy.—Forty cm. of small intestine dark red, distended.