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PATHOLOGY OF SHOCK IN MAN: VISCERAL EFFECTS OF TRAUMA, HEMORRHAGE, BURNS AND SURGICAL OPERATIONS

PATHOLOGY OF SHOCK IN MAN: VISCERAL EFFECTS OF TRAUMA, HEMORRHAGE, BURNS AND SURGICAL OPERATIONS Abstract Present knowledge of the syndrome of shock in man rests largely on physiologic investigations in lower animals. Studies of pathologic changes are decidedly more limited, and Moon and Kennedy1 deserve much credit for drawing attention to the importance of these alterations. The present study is concerned with the visceral changes present in 50 patients who died in a state clinically diagnosed as shock and on whom postmortem examinations were performed from one to three hours later. An effort has been made to demonstrate that definite alterations occur in the viscera as the result of shock and that the character of these changes is dependent on the etiologic factors involved. The changes are grouped according to the clinical states from which they arose, and their significance is briefly discussed. These states include: 1. Cerebral trauma—10 cases A. Early death B. Delayed death 2. Trauma to the abdomen, thorax or extremities—31 References 1. Moon, V. H., and Kennedy, P. J.: Pathology of Shock , Arch. Path. 14:360-371 ( (Sept.) ) 1932. 2. Davis, H. A.: Unpublished data. 3. Alajouanine, T., and Hornet, T.: L'oedème cérébral generalisé (étude anatomique) , Ann. d'anat. path. 16:133-163 ( (Feb.) ) 1939. 4. Wanke, R.: Zum Nachweis und zur Auswirkung der traumatischen Hirnstammläsion , Arch. f. klin. Chir. 193:676-701, 1938. 5. Blalock, A., and Bradburn, H. B.: Trauma to Central Nervous System: Its Effects on Cardiac Output and Blood Pressure; Experimental Study , Arch. Surg. 19:725-734 ( (Oct.) ) 1929.Crossref 6. Hepler, O. E., and Simonds, J. P.: Mechanism of Shock: Effects of Intravenous Injection of Salt Solution in Collapse Induced by Mechanical Impounding of Splanchnic Region in Normal and Hyperthyroid Dogs , Arch. Path. 25:149-159 ( (Feb.) ) 1938. 7. Belt, T. H.: Liver Necrosis Following Burns, Simulating the Lesions of Yellow Fever , J. Path. & Bact. 48:493-498 ( (May) ) 1939. 8. Bardeen, C. R.: A Review of the Pathology of Superficial Burns with a Contribution to Our Knowledge of the Pathological Changes in the Organs in Cases of Rapidly Fatal Burns , Johns Hopkins Hosp. Rep. 7:137-179, 1898. 9. Underhill, F. P.; Carrington, G. L.; Kapsinow, R., and Pack, G. T.: Blood Concentrations in Extensive Superficial Burns, and Their Significance for Systemic Treatment , Arch. Int. Med. 32:31-49 ( (July) ) 1923. 10. Harkins, H. N.: Experimental Burns: I. Rate of Fluid Shift and Its Relation to the Onset of Shock in Severe Burns , Arch. Surg. 31:71-85 ( (July) ) 1935. 11. Wilson, W. C.; Jeffrey, J. S.; Roxburgh, A. N., and Stewart, C. P.: Toxin Formation in Burned Tissues , Brit. J. Surg. 24:601-611 ( (Jan.) ) 1937. 12. Davis, H. A., and Jermstad, R. J.: Regional Distribution of Blood in Experimental Secondary Shock , Arch. Surg. 38:556-580 ( (March) ) 1939. 13. Sheehan, H. L.: The Pathology of Obstetric Shock , J. Obst. & Gynaec. Brit. Emp. 46:218-231 ( (April) ) 1939. 14. Külbs, F., and Strauss, H.: Ueber subendokardiale Blutungen , Klin. Wchnschr. 12:933 ( (June) ) 1933. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

PATHOLOGY OF SHOCK IN MAN: VISCERAL EFFECTS OF TRAUMA, HEMORRHAGE, BURNS AND SURGICAL OPERATIONS

Archives of Surgery , Volume 41 (1) – Jul 1, 1940

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References (15)

Publisher
American Medical Association
Copyright
Copyright © 1940 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1940.01210010126012
Publisher site
See Article on Publisher Site

Abstract

Abstract Present knowledge of the syndrome of shock in man rests largely on physiologic investigations in lower animals. Studies of pathologic changes are decidedly more limited, and Moon and Kennedy1 deserve much credit for drawing attention to the importance of these alterations. The present study is concerned with the visceral changes present in 50 patients who died in a state clinically diagnosed as shock and on whom postmortem examinations were performed from one to three hours later. An effort has been made to demonstrate that definite alterations occur in the viscera as the result of shock and that the character of these changes is dependent on the etiologic factors involved. The changes are grouped according to the clinical states from which they arose, and their significance is briefly discussed. These states include: 1. Cerebral trauma—10 cases A. Early death B. Delayed death 2. Trauma to the abdomen, thorax or extremities—31 References 1. Moon, V. H., and Kennedy, P. J.: Pathology of Shock , Arch. Path. 14:360-371 ( (Sept.) ) 1932. 2. Davis, H. A.: Unpublished data. 3. Alajouanine, T., and Hornet, T.: L'oedème cérébral generalisé (étude anatomique) , Ann. d'anat. path. 16:133-163 ( (Feb.) ) 1939. 4. Wanke, R.: Zum Nachweis und zur Auswirkung der traumatischen Hirnstammläsion , Arch. f. klin. Chir. 193:676-701, 1938. 5. Blalock, A., and Bradburn, H. B.: Trauma to Central Nervous System: Its Effects on Cardiac Output and Blood Pressure; Experimental Study , Arch. Surg. 19:725-734 ( (Oct.) ) 1929.Crossref 6. Hepler, O. E., and Simonds, J. P.: Mechanism of Shock: Effects of Intravenous Injection of Salt Solution in Collapse Induced by Mechanical Impounding of Splanchnic Region in Normal and Hyperthyroid Dogs , Arch. Path. 25:149-159 ( (Feb.) ) 1938. 7. Belt, T. H.: Liver Necrosis Following Burns, Simulating the Lesions of Yellow Fever , J. Path. & Bact. 48:493-498 ( (May) ) 1939. 8. Bardeen, C. R.: A Review of the Pathology of Superficial Burns with a Contribution to Our Knowledge of the Pathological Changes in the Organs in Cases of Rapidly Fatal Burns , Johns Hopkins Hosp. Rep. 7:137-179, 1898. 9. Underhill, F. P.; Carrington, G. L.; Kapsinow, R., and Pack, G. T.: Blood Concentrations in Extensive Superficial Burns, and Their Significance for Systemic Treatment , Arch. Int. Med. 32:31-49 ( (July) ) 1923. 10. Harkins, H. N.: Experimental Burns: I. Rate of Fluid Shift and Its Relation to the Onset of Shock in Severe Burns , Arch. Surg. 31:71-85 ( (July) ) 1935. 11. Wilson, W. C.; Jeffrey, J. S.; Roxburgh, A. N., and Stewart, C. P.: Toxin Formation in Burned Tissues , Brit. J. Surg. 24:601-611 ( (Jan.) ) 1937. 12. Davis, H. A., and Jermstad, R. J.: Regional Distribution of Blood in Experimental Secondary Shock , Arch. Surg. 38:556-580 ( (March) ) 1939. 13. Sheehan, H. L.: The Pathology of Obstetric Shock , J. Obst. & Gynaec. Brit. Emp. 46:218-231 ( (April) ) 1939. 14. Külbs, F., and Strauss, H.: Ueber subendokardiale Blutungen , Klin. Wchnschr. 12:933 ( (June) ) 1933.

Journal

Archives of SurgeryAmerican Medical Association

Published: Jul 1, 1940

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