Two cases of aneurysm of the splenic artery / by R.S. Taylor and John H. Teacher.

  • Taylor, R. S.
Date:
[1911]
Catalogue details

Licence: In copyright

Credit: Two cases of aneurysm of the splenic artery / by R.S. Taylor and John H. Teacher. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    Heart.—Both ventricles showed considerable hypertrophy and dilatation, with good healthy muscular wall. The aortic valves were incompetent. Large shaggy masses of vegetations in proccess of breaking down were present on all three aortic cusps. There was some old-standing thickening of the aortic and mitral valves, but no adhesion of the cusps. There was some thickening of the endocardium, extending down for nearly an inch from the aortic opening, and over this and the ventricular surface of the anterior mitral cusp were numerous recent vegetations. There was a ring of recent small vege- tations on the lines of contact of the mitral valves. The pulmonic and tricuspid valves were healthy. There was a small aneurysmal dilatation at the commencement of the aorta, involving the orifice of the right coronary artery. Abdomen.—The liver and kidneys showed the changes associated with chronic venous congestion. The spleen was greatly enlarged, with deep puckering of the surface and some perisplenitis, Half of the spleen was examined at once, and the remainder preserved for further investigation. The puckerings on the surface were cicatrices resulting from old infarctions. There was also a large recent hfemorrhagic infarction. The portion of spleen examined contained several large masses of laminated thrombus, enclosed in cavities with definite smooth walls, and the cavities communicated with one another. There were a number of enlarged caseous mesenteric glands, but neither ulcers nor tubercles could be found in the bowel. The mediastinal glands were also slightly enlarged, but not caseous. Brain.—There was a little haemorrhage into the pia- arachnoid over the right parietal region, and the whole right hemisphere showed very considerable bulging. In the bifurcations of almost all the smaller vessels at the base there were loose plugs, corresponding in macroscopical characters to the vegetations on the aortic valves. There was a small area of softening in the left frontal lobe. There was a very large haemorrhage into the right cerebral hemi- sphere which had ploughed up the brain substance so much that its source could not be traced. Films made from the spleen by direct smear showed large endothelial cells in various stages of disintegration, and a few polymorphonuclear leucocytes, but no organisms. Sections of the cardiac valves were also stained for organisms, with negative result.