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MULTIPLE NON-INFLAMMATORY NECROSIS OF THE LIVER WITH JAUNDICE IN CHRONIC CYANOSIS

HORST OERTEL, M.D.
Arch Intern Med (Chic). 1910;VI(3):NP. doi:10.1001/archinte.1910.00050310063004.
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Fig. 1.—Section of liver.

A man, 25 years old, entered Dr. Potter's service at the City Hospital, on Sept. 3, 1909, with typical symptoms of mitral stenosis and evidences of general stasis. These symptoms became aggravated and the patient rapidly developed considerable edema, fluid in his chest, pulsating veins and pulsating and distinctly enlarged liver.

On October 8 there was observed for the first time faint jaundice; the leukocyte count was then 8,400. On the 11th the jaundice had become marked, and there was occasional vomiting of brown fluid. The stools were formed, brown and contained blood. On the 13th, he had epistaxis and considerable blood in his sputum. On the 16th, his jaundice had deepened; there was hemorrhage from the bowels. The stools were loose, yellowish and contained mucus. He rapidly became weaker and died with deep jaundice on October 18. The fatal period was unaccompanied by

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