[Significance of bacterial shock to thanatogenesis in peritonitis]

Fifty-three section examinations of peritonitis with a history of 1 to 30 days were performed to microscopically study viscera and their microcirculatory bed. They revealed microcirculatory disturbances and their consequences that were characteristic of shock. They were most of all pronounced in the kidneys and lungs. The kidneys showed blood dumping with cortical ischemia, which was accompanied with dystrophic changes in the proximal nephroepithelium or focal acute renal failure (ARF) in half the cases. Seven cases displayed advanced ARF of over 8-10-day history with regeneration in the damaged tubules. There were pulmonary microcirculatory disturbances in 27 cases, 10 of them having clinical signs of the "shock" lung, i.e. dys- and atelectases, alveolar bleedings, hyalin membranes, which might be a cause of acute respiratory failure.