FATAL ACUTE HEPATITIS

Abstract
Hemorrhagic manifestations in the course of acute hepatitis are generally of grave prognostic omen since they signify widespread destruction of the hepatic parenchyma. Thus, in a review by Lucké1of the pathology of epidemic hepatitis in 125 fatal cases observed in the armed forces in various theaters during World War II, 109 had evidence of bleeding phenomena. Hemorrhages were observed most commonly in the intestinal and respiratory tracts, then in decreasing frequency in the epicardium or endocardium, kidneys, skin, and brain. In a subsequent dicussion by Lucké and Mallory2of an additional series of 196 cases of a fulminant form of the disease often terminating fatally in 10 days or less, mention is again made of gastrointestinal hemorrhages and widespread purpuric phenomena. Sporadic occurrence of acute hepatitis is no longer rare in civilian practice, and the clinical and pathological pictures are comparable with those observed during mass outbreaks

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