The pancreas was examined histologically in 146 cases of patients dying of shock. The finding of morphological evidence of disseminated intravascular coagulation (DIC) in the pancreas supports the opinion that the pancreas in highly sensitive to disturbances of blood perfusion. The presence of DIC combined with a variety of pathological lesions in the exocrine ad endocrine pancreas was sufficiently characteristic to justify use of the term " shock pancreatitis". The relative scarcity of data hitherto available on pathological changes in the pancreas caused by shock can be ascribed to changes in the management of shock. It is concluded that the pancreatic lesions described in this study could influence the outcome in shock treated by modern methods of resuscitation.
Autoimmune hepatitis type 1 in a 8-year old girl is described. The diagnosis was established using International Autoimmune hepatitis group scoring system. In addition to characteristic histologic features of autoimmune hepatitis (periportal hepatitis, piecemeal necrosis and rozettes) prominent centrilobular necrosis was discovered. As an isolate finding in autoimmune hepatitis, this type was described only in five cases. In our unique case centrilobular necrosis is a very important parallel finding previously not detected in autoimmune hepatitis. Some experimental studies suggest that cytocins present in inflammatory cell infiltrate in the liver play a pathologic role in autoimmune liver cell damage.
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