Fig. 72.—Appearance of a portion of the small intestine in chronic diarrhœa.
Complications are rare, though occasionally intestinal hæmorrhage or broncho-pneumonia occurs. The temperature, which remains normal or shows very slight changes throughout the course of the disease, may then oscillate between 101° and 103° Fahr. (38° and 39·5° C.).
Fig. 73.—Atheromatous lesions of the aorta in chronic diarrhœa.
Lesions. At the first glance no lesions can be detected on post-mortem examination except those of generalised wasting, but when the autopsy is carried out immediately after death all the interior of the intestine appears affected. The mucous membrane of the abomasum and the mucous folds appear infiltrated, thickened, and with moderate sub-epithelial congestion. The intestine seems friable, and tears with the slightest traction. The sub-epithelial portions of the mucous folds are infiltrated and congested, while the more prominent parts of the folds, which are exposed to the friction of semi-digested food, become eroded.
Throughout the length of the jejeunum and ileum the mucous membrane exhibits multitudes of small ulcerations.
Histologically, the epithelium and the glands seem atrophied, without any inflammatory change having occurred in the mucous or submucous coats.
The colon and the cæcum show similar lesions, and in addition brown deposits of pigment under the mucous membrane and along the course of the small blood-vessels. This lesion resembles that found in chronic dysentery in man, and suggested to Moussu a possible connection between the two diseases.
The liver is less than the normal size. In the heart Moussu has seen one case of sclerosis of the auricles and calcareous infiltration of the sub-endothelial lining of the aorta.
In several instances he has noted calcareous infiltration of the mesenteric lymphatic gland.