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

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Abstract
The following pathologic changes were found in the viscera of dogs that died as a result of muscle trauma: Lungs[long dash]congestion and patchy consolidation that was not constant or extensive. The mucosa of the upper gastrointestinal tract and descending colon[long dash]congestion, hemorrhage, and at times small areas of erosion. Liver[long dash]congestion of the sinusoids in dogs that died soon after trauma; in those dying later than 3 hrs. after trauma, degeneration of cord cells in the region of the central vein. Animals surviving longer than 18 hrs. showed little or no cellular degeneration. Kidneys[long dash]congestion of capillary tufts and other small vessels was seen in those dogs dying soonest. Sections from dogs that died 3 hrs. or more after trauma showed various degrees of degenerative changes in the tubules. Adrenal cortex[long dash]congestion was apparent in animals dying within an hr. of trauma. In later deaths, infiltration of leucocytes and degeneration of cells were notable features. Gross hemorrhages were present in dogs that died after 5 hrs. Severe cortical changes were found in 2 dogs that bled to death accidentally at 8 and 101/2 hr. 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 1 of these dogs appeared practically normal. Pancreas[long dash]little congestion was seen in dogs that died within 5 hrs. 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 oligemia, to the tissue changes observed.