Naslov
Patomorfološki ekvivalenti šoka u djece
(Pathomorphological Equivalents of Shock in Children)

Autori
Pirkić, Ahmed

Izvornik
Arhiv za zaštitu majke i djeteta (0004-1289) 27 (1983), 1; 105-119

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, pregledni rad, znanstveni

Ključne riječi
dijete; šok; patomorfološki ekvivalenti
(child; shock; pathomorphological equivalents)

Sažetak
Reactions of the child´s organism differ from those in adults, because in the formal genesis of morphologic changes there is the immaturity of tissues and organs, an increased proneness to permeability changes, and the immaturity of the coagulation system. From numerous definitions of shock it comes out that cardinal changes in states of shock occur in peripheral blood vessels and in microcirculation. At the autopsy of those, died in shock a pratical pathologist most frequently finds interstitial edema, microthrombosis and bleeding ; these changes are pathogenetically connected. A great many factors may lead to the development of interstitial edema, one of the most common being the impairment of endothelial cells coupled with defective coagulation. Microthrombosis is the result of consumption coagulopathy. Bleeding develops either as the result of consumption coagulopathy, or the injuries of the wall of blood vessels. Pathoanatomical changes of individual organs in shock are not specific. In the kidney there may develop an extensive interstitial edema, and the dilatation of canaliculi, the epithelium of which is flattened. In the lungs, along with a venous-capillary prestatic hyperemia, there first develops interstitial edema and hyaline membranes and later fibrosis due to tissue proliferation. In the brain, purpura can often be observed, as well as symmetric encephalomalacia and subarachnoid and ventricular bleeding. In the gastrointestinal tract, hemorrhagic erosions and hemorrhagic gastroenteritis can be found, in the liver perivenous sinusoidal hyperemia, focal bleeding, and hepatocyte necrosis. Bleeding is a frequent finding in adrenal glands. In addition, basic experimental and morphological data on hypothermal shock are briefly presented. The importance of brown fat tissue in thermoregulation processes is pointed out. Pre-term acidosis-threatened children and prematures adapt themselves to hypothermal conditions with difficulty or do not adapt themsleves at all.

Izvorni jezik
Hrvatski

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