脳出血を合併し十二指腸潰瘍穿孔で死亡した悪性高血圧の一剖検例

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A 45 year-old man was admitted to our hospital becasue of headache and fatigue. On admission, blood pressure was 260/150 mmHg The heart was definite left ventricular hypertrophy.<BR>The retinal changes was Keith Wagener III ; the renal function was slightly disturbed and plasma renin activity was 2.3 ng/ml/hour. On 104th hospital day, he died of cerebral haemorrhage and perforation of duodenal ulcer.<BR>Histological findings showed fibrinoid necrosis of affrent arteriole and a part or complete necrosis of glomerulus. Duodenum showed perforation of little finger's head sized ulcer with infiltration of inflammatory cell and proliferation of fibrous connective tissues histologically.<BR>The brain was 1340 g in weight and showed thumb's head sized hemorrhages in the area of left lenticular nucleus without fibrinoid changes of blood-vesseles.<BR>Fibrinoid necrosis of arterioles was noticed in adrenocortex, periadrenal tissues and pancreatic parenchyma and environs. This patient died with haemorrhage of cerebral and perforation of duodenal ulcer on the state of premalignant phase.
学校法人昭和大学・昭和医学会の論文