Indurative mediastino-pericarditis / by Thomas Harris.

  • Harris, Thomas.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Indurative mediastino-pericarditis / by Thomas Harris. Source: Wellcome Collection.

    30/78 (page 24)
    coat of the intestines was somewhat thickened, and presented numerous closely packed rounded white spots. These at first sight had much the appearance of tubercles, but were not so raised, and were evidently localised spots of thickening of the serous coat of a fibroid character. There were no adhesions of the coils of the intestine to each other, but there was much peritoneal matting in the neighbourhood of the spleen, which was firmly fixed by such adhesions to the under surface of the diaphragm. A few similar adhesions united the upper surface of the liver to the diaphragm. Liver : Not markedly differing in size from what one would expect in a child, but the edges were very rounded, this apparently being caused by the contraction of the pi-eviously described thickened capsule. The capsule was everywhere much thickened, and of the opaque white porcelain-like aspect previously mentioned. The organ was adherent to the under surface of the diaphragm. On section the organ was extremely congested, presenting a typical myristicated appear- ance, but apparently little or no cirrhosis. No evidence of tubercle or of old caseous foci.- The inlet of the hepatic veins into the hepatic portion of the inferior vena cava did not appear to be mechanically obstructed by direct fibrous compression, and there was no narrowing of the inferior vena cava at its entrance into the right auricle. The measurements of the liver were as follows : Vertical, 4in. anteriorly, and i^in. posteriorly, transverse, 8Jin. The weight of the organ cannot be given, as it was desired to leave it attached to the thoracic organs and diaphragm for museum purposes. Spleen: Congested; not, however, markedly enlarged; capsule thickened, of dense opaque white porcelain-like aspect, but this not to so marked a degree as is the case with the capsule of the liver. Kidndjrs: Both markedly congested, but not otherwise presentmg any abnormal appearances. Retroperitoneal lymphatic glands: Not enlarged. No signs of caseation or calcareous change in any of the glands. Brain not examined for reasons previously stated. Microscopical examination of the liver showed immense venous engorgement J the capillaries of the central portion of the lobules were enormously distended, and a great part of the lobule presented simply a network of engorged capillaries with no liver cells. A little more remote from the centre of the lobule the vessels were still engorged, and the liver cells between them atrophied and pigmented. At the periphery of the lobules the liver cells were fairly healthy, except that some of them contained a large amount of fat. The periportal tissue showed very little change; it was nowhere markedly increased, but was possibly slightly in excess of the