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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    diarrhea, not bloody. No vomiting, but hemoptysis present. Temperature slightly raised. Autopsy.—Total occlusion of superior mesentery artery from atheromatous aorta. Infarct of small intestine; thin, hem- orrhagic fluid contents. Gut wall much thickened with hem- orrhage; its wall covered with slight fibrinous exudate. Car- diac hypertrophy and aortic insufficiency. Roughened aorta. Source of thrombus not definitely made out. Councilman.—Woman, 85 years. Has had bronchitis at in- tervals. First symptom, pain in abdomen, vaguely referred to right iliac fossa, and growing worse after a few hours. This lasted through whole illness. Died in twelve days. After second day abdomen was distended. Constipation, with no re- sult from enemata, and no gas. Vomiting began on the fourth day, becoming fecal at the end. Temperature until the eighth day was subnormal, then rose to 101.5. Pulse 70. Autopsy.—Marked atheroma of aorta, with parietal thrombi. One of these extends into the superior mesenteric artery, not wholly closing the lumen. Intestine distended, only moder- ately reddened, however. No intestinal infarction. Marked distension of the gut. Heart muscle very friable. The slight amount of blood which reached the intestines was insufficient, thus causing obstruction. Deckart.—Woman, 53 years. For past five years com- plained of short breath, easily tired, palpitation, dizziness, etc. For fourteen days broken compensation. Diagnosis: Mitral insufficiency, arteriosclerosis, myocarditis, emphysema. Im- proved under treatment. Was allowed to sit up. Collapsed. Complained of pain in abdomen. Mass in hypograstrium very tender on pressure. Visible peristalsis in upper part of abdo- men. Frequent vomiting, at first bile stained, later becoming fecal. Constipated; few scybalae after enema, never any blood. Rectal and vaginal examination negauve. Indoxyl in urine markedly increased. Pulse 120 to 150. Temperature 37 C. Operation—Sero-hemorrhagic fluid in abdominal cavity. In- testines dark. Artificial anus made. Collapse with pulse of 50. Death. Autopsy.—Lower jejunum and upper ileum infarcted. Clot in one of main branches of superior mesenteric artery. Deckart.—Woman, 47 years. For seven years following a fever has had frequent vomiting, headache, dizziness and swol- len feet. Later perspiration and diminished vision. One attack of uremia relieved by venesection. Symptoms of uremia and anemia. Several days before death had severe colicky pains in abdomen. The stools were bloody. Cardiac dullne-> increased to left. Abdomen boat-shaped. Albumin and casts in urine, no blood. Retinal hemorrhages. Once during illness had many petechise on thighs and abdomen. Autopsy.—One hundred c.c. fluid in Douglass fossa. Throm-