Hemorrhagic Necrosis of the Gastrointestinal Tract and Its Relation to Cardiovascular Status

Abstract

Seventy-five cases of hemorrhagic necrosis of the gastrointestinal tract were analyzed and compared with the entire autopsy population as control. The disease occurred most frequently in association with shock, which was present in 80 per cent of the cases with the gastrointestinal lesions. The incidence of heart disease was higher in the cases of hemorrhagic necrosis than in the control group. The role of cardiac dysfunction in the etiology of hemorrhagic necrosis is emphasized as are the roles played by the bacterial toxins and shock. All three conditions have been shown to result in marked reduction of the intestinal blood flow and venous stasis. Hemorrhagic necrosis of the gastrointestinal tract probably represents a conglomeration of microinfarcts of the mucosa secondary to markedly decreased local blood flow. Vasopressor agents have produced no beneficial effect; the effect of vasodilators remains to be determined.