Ultrastructure of the Kidney in Tourniquet Shock

Publisher Website
Google Scholar
Abstract
Light microscopical and ultrastructural changes in the rat kidney in tourniquet shock are described. The animals were killed 2, 4, 8 and 24 h after release of tourniquets and two animals (4 and 24 h) were resuscitated with injections of saline. On light microscopy of paraffin-embedded tissue, no changes were apparent. In Epon-embedded sections, there were apparently more cytosomes of proximal tubule cells and increased apical vacuolation in the tubule cells. Disintegrated cells in the tubuli appeared at 24 h. On electron microscopy, the first changes were found at 4 h. In these samples, cytosomes in the proximal tubules appeared increased and apical vacuolation was evident in collecting ducts. Occasional dead cells were seen in the interstitial tissue and in the glomeruli. Platelets were seen attached on capillary walls but evidence of occluding thrombi was absent. At 8 h, proximal tubule cells showed various kinds of large vacuoles and cytosomes, usually situated at the apical part of the cell. Rupture of the limiting membranes of the cytosomes was seen occasionally. In distal tubuli, degenerated cell material was seen. At 24 h, degenerated cell debris was seen in the tubular lumina together with signs of necrosis and exfoliation of distal tubule cells. Apical vacuolation was seen in otherwise preserved epithelial cells. In the saline-resuscitated rat, haemolysis had occurred in the capillaries. The changes in the tubules were patchy and there were apparently unaffected areas between the lesions in the cortex. It is suggested that the pathological changes of tourniquet shock are based on the combined action of hypovolaemia due to limb oedema and circulating factors liberated from the ischaemic tissues.

This publication has 0 references indexed in Scilit: