STUDIES OF SHOCK PRODUCED BY MUSCLE TRAUMA: II. PATHOLOGICAL CHANGES IN VARIOUS TISSUES

Abstract

The following pathological changes were found in the viscera of dogs that died as a result of muscle trauma: (a) Lungs—congestion and patchy consolidation that was not constant or extensive. (b) The mucosa of the upper gastrointestinal tract and descending colon—congestion, haemorrhage, and at times small areas of erosion. (c) Liver—congestion of the sinusoids in dogs that died soon after trauma; in those dying later than three hours after trauma, degeneration of cord cells in the region of the central vein. Animals surviving longer than 18 hr. showed little or no cellular degeneration. (d) Kidneys—congestion of capillary tufts and other small vessels was seen in those dogs dying soonest. Sections from dogs that died three hours or more after trauma showed various degrees of degenerative changes in the tubules. (e) Adrenal cortex—congestion was apparent in animals dying within an hour of trauma. In later deaths, infiltration of leucocytes and degeneration of cells were notable features. Gross haemorrhages were present in dogs that died after five hours. Severe cortical changes were found in two dogs that bled to death accidentally at 8 and [Formula: see text]. after trauma despite a well maintained blood pressure up to the time of death; mild renal degenerative changes were present in both; a liver section obtained from one of these dogs appeared practically normal. (f) Pancreas—little congestion was seen in dogs that died within five hours after trauma but was more evident in dogs that died later and, in this respect, paralleled the gross changes in the adrenal glands.The findings are discussed and it is concluded that absorption of toxic substances from the damaged muscles contributed, along with the secondary effects of oligaemia, to the tissue changes observed.