Sarcoma and cirrhosis of the liver / by W.W. Ford.

  • Ford, William W. (William Webber), 1871-1941.
Date:
[between 1895 and 1910?]
Catalogue details

Licence: Public Domain Mark

Credit: Sarcoma and cirrhosis of the liver / by W.W. Ford. Source: Wellcome Collection.

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    diagnosis to be made. The possibility of its being a case of haemophilia occurred to me, but the age of the child, the association of febrile tem¬ perature, and the absence of history, seemed to preclude any etiological relationship. The post-mortem examination was made by the pathologist of the Maternity Hospital, Dr. Joseph Sailer, to whom I desire to express my most sincere thanks. The notes were elaborate, and from them I have abstracted the most important facts. The body was decidedly emaciated. A large, distinct, hemorrhagic effusion noticed around the umbilicus. Abdominal cavity : No subcutaneous fat. Hemorrhage noted into the wall of the umbilical cord, and hemorrhagic effusion into the peritoneum. The caecum was distended and somewhat adherent to the abdominal wall. In the neighborhood of the umbilical artery the peritoneum was dry and sticky. The ileum was of a slaty color, due to contained blood. The mesentery was intensely congested. The mesenteric glands not enlarged. No ecchymotic hemorrhages. Thoracic cavity: Pleural cavities were free and contained no fluid. The pericardium was smooth, but intensely congested, particularly along the line of the anterior coronary artery. The lungs : Pale. Numerous subpleural ecchymoses, and some areas of consolidation were found on the right side. The heart: The right auricle was distended with blood. The foramen ovale was widely patulous. No coronary valve was present. The ductus arteriosus was not investigated. Otherwise the heart was normal. The spleen: Normal. The ileum : Filled with a dark-brown granular mass, which was readily removed, leaving a smooth, glistening and pale mucous membrane which showed no congestion. The folds of the ileocsecal valve contained a firm, slightly adherent clot. There was no sign of ulceration in the intestinal tract. The common bile duct was patulous. The mucous membrane of the duodenum was clear and but slightly bile-stained. The stomach contained a small amount of bile, but no blood. The mucous membrane was very rugous. There were no ecchymoses. The oesophagus was filled with blood-stained mucous. The liver was enlarged and soft, and its surface on section was dis¬ tinctly cloudy. The structure was indistinct. The pancreas was soft. There was no hemorrhage present, and its structure appeared to be normal. The adrenals and kidneys were both apparently normal. The brain was apparently oedematous. The membranes were very cloudy. There were no hemorrhages either into the substance or ventricles. The histological and bacteriological examinations were made by Dr. Sailer in the Pathological Laboratory of the University of Pennsylvania. On section through the duodenum some superficial necrosis in the mucous membrane was present, and also moderate proliferation of the epithelium cells of the villi. Very slight perivascular round-cell infiltra¬ tion in the submucosa. The muscularis was normal. There was a slight exudate on serous coat. High magnification gave some cloudy swelling in the epithelial cells of the villi, and many of the cells were seen to contain swollen and pale nuclei. The walls of the bloodvessels were found to be slightly thickened.