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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    Microscopic Examination.—A slight increase of the fibrous tissue was found between the bundles of muscular fibers, which were somewhat atrophied, otherwise there was nothing remarkable. Lungs.—Somewhat adherent to the chest cavity and rather engorged in blood in the dependent portions, but otherwise not remarkable. Abdominal Cavity.—Contained a moderate amount of bloody, serous fluid. The coils of the intestines were very much dis- tended with gas and of a dark, bluish-red color. The stomach itself was normal. The ileum, for the greater part of its course, was discolored, bluish-red in color, the membrane in- jected with a little bloody mucus in the interior, and about midway in this part the walls were thickened through infiltra- tion of blood. On section the veins leading to this point were found filled with a dark red, loosely adherent antemortem thrombus. The lower two feet of the ileum and the head of the colon were normal. The greater part of the ascending and transverse colon presented a similar aspect to that of the ileum but less in extent. The veins leading to this were also found to be thrombosed in a like manner. Pancreas.—It was imbedded in fatty tissue, but appeared normal to the eye. Liver.—Was of normal size. On section it was rather opaque and yellow with indistinct lobular markings. Micro- scopic examination showed atrophy of the liver columns, slight increase of the fibrous tissue and fatty infiltration of the cells. Spleen.—Small and soft. Kidneys.—One of them weighed 200 grams. On section the surface was somewhat pale, slightly opaque with marked in- jection at the base of the pyramids. Microscopic Examination.—The vessels of the malpighian bodies were found to be dilated and the connective tissue be- tween the tubules was increased, with a marked atrophy and granular degeneration of the epithelium. The arteries of the kidney were considerably thickened, but this was in general diffuse. In the straight tubules were a few hyaline casts. The thrombosed vessels in the mesentery showed very little change in the wall of the vein that would be regarded as a cause for the thrombosis. In one of the pieces examined, in addition to the vein, a small artery was also found to be throm- bosed, the wall of which showed a marked thickening and ir- regularity of the intima, and to which a thrombosis was very intimately adherent, and seemed as if it might have been the starting point of the process. Diagnosis.—Arteriosclerosis with hypertrophy of the heart; slight, chronic interstitial myocarditis; hepatitis and ne- phritis; thrombosis of the mesenteric vein and artery; infarc- tion of the intestine; commencing gangrene.