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Hepatic Lesion of Hemorrhagic Shock

Hepatic Lesion of Hemorrhagic Shock Abstract Diffuse congestion of capillaries and venules in visceral areas has been described by Moon1 as the lesion of hemorrhagic shock. Wiggers2 regarded pathologic changes having real bearing on the functional derangements of hemorrhagic shock to be the firmly contracted spleen and distinctive changes in intestinal mucosa; that is, hyperemia, congestion, edema, and petechial hemorrhage. More recently, attention has been focused on acute tubular necrosis, the renal lesion of shock from hemorrhage and injury. Fine3 and others, however, have come to the conclusion that the liver is the locus of the primary defect of irreversible hemorrhagic shock. In the present study histologic observations were made on tissues from dogs subjected to hemorrhagic shock. A hepatic lesion was consistently observed in animals subjected to hemorrhage and transfusion of shed blood. Criteria differentiating the observed lesion from chronic passive congestion or hyperemia are proposed. Methods and Materials Gross and microscopic References 1. Moon, V. H.: Shock and Related Capillary Phenomena , New York, The Oxford University Press, 1938. 2. Wiggers, C. J.: The Physiology of Shock , Cambridge, Mass., Commonwealth Fund Div. of Publications, Harvard University Press, 1950. 3. Fine, J.: Symposium on Liver Function , Publication No. 4, American Institute of Biological Sciences, 1958, p. 585. 4. Visscher, M. B., and Henschel, A.: Amer. Heart J. 30:592, 1945.Crossref 5. Wiggers, C. J.: Physiol. Rev. 22:74, 1942. 6. Knisely, M. H.; Block, E. H., and Warner, L.: Selective Phagocytosis, Kongelige Danske Videnskabernes Selskab , Biol. Skrift. 4:1, 1948. 7. Brill, N. R., and Shoemaker, W. C.: Surg. Forum 11:120, 1960. 8. Shoemaker, W. C.; Walker, W. F., and Turk, L. N.: Surg. Gynec. and Obstet. 112:327, 1961. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Hepatic Lesion of Hemorrhagic Shock

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Publisher
American Medical Association
Copyright
Copyright © 1962 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1962.01310030140022
Publisher site
See Article on Publisher Site

Abstract

Abstract Diffuse congestion of capillaries and venules in visceral areas has been described by Moon1 as the lesion of hemorrhagic shock. Wiggers2 regarded pathologic changes having real bearing on the functional derangements of hemorrhagic shock to be the firmly contracted spleen and distinctive changes in intestinal mucosa; that is, hyperemia, congestion, edema, and petechial hemorrhage. More recently, attention has been focused on acute tubular necrosis, the renal lesion of shock from hemorrhage and injury. Fine3 and others, however, have come to the conclusion that the liver is the locus of the primary defect of irreversible hemorrhagic shock. In the present study histologic observations were made on tissues from dogs subjected to hemorrhagic shock. A hepatic lesion was consistently observed in animals subjected to hemorrhage and transfusion of shed blood. Criteria differentiating the observed lesion from chronic passive congestion or hyperemia are proposed. Methods and Materials Gross and microscopic References 1. Moon, V. H.: Shock and Related Capillary Phenomena , New York, The Oxford University Press, 1938. 2. Wiggers, C. J.: The Physiology of Shock , Cambridge, Mass., Commonwealth Fund Div. of Publications, Harvard University Press, 1950. 3. Fine, J.: Symposium on Liver Function , Publication No. 4, American Institute of Biological Sciences, 1958, p. 585. 4. Visscher, M. B., and Henschel, A.: Amer. Heart J. 30:592, 1945.Crossref 5. Wiggers, C. J.: Physiol. Rev. 22:74, 1942. 6. Knisely, M. H.; Block, E. H., and Warner, L.: Selective Phagocytosis, Kongelige Danske Videnskabernes Selskab , Biol. Skrift. 4:1, 1948. 7. Brill, N. R., and Shoemaker, W. C.: Surg. Forum 11:120, 1960. 8. Shoemaker, W. C.; Walker, W. F., and Turk, L. N.: Surg. Gynec. and Obstet. 112:327, 1961.

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1962

References