Summary
A steam-tube of the main boiler exploded on a ship lying in the harbour of Hamburg. The steam temperature was 283‡ C. Cutaneous and severe inhalational scalding occured in the 27 fatalities, the men dying after different intervals.
This paper deals with the pathological findings in the respiratory passages and the lung, describing the topographical extent of direct thermal injury and the temporal course of tissue reactions.
In cases of instantaneous death coagulation necrosis of the tracheal and bronchial wall was found to extend to alveolar ducts in central parts of the lung. The lung parenchyma showed marked congestion, alveolar edema and desquamation of alveolar epithelial cells. Death occured due to acute pulmonary dysfunction and shock.
Lethal complications following the period of primary shock consisted of fulminant confluent bronchopneumonia, the hyaline membrane syndrome or the onset of desquamative interstitial pneumonia. These changes rendered it difficult to evaluate the effects of the heavy cutaneous scalding on the pathological course of inhalational injuries in those surviving for longer periods.
Similar content being viewed by others
Reference
Achauer, B.M., Allyn, P.A., Furnas, D.W., Bartlett, R.H.: Pulmonary complications of burns. Ann. Surg. 177, 311–319 (1973)
Allgöwer, M., Siegrist, J.: Verbrennungen. Berlin-Göttingen-Heidelberg: Springer 1957
Aviado, D.M., Schmidt, C.F.: Respiratory burns with special reference to pulmonary edema and congestion. Circulation 6, 666–680 (1952)
Di Vincenti, F.C., Pruitt, B.A., Reckler, J.M.: Inhalation injuries. J. Trauma 11, 109–116 (1971)
Femenic, B.: Changes in the tracheal respiratory mucosa of rats following experimentally induced burns of the skin. Pract. oto-rhino-laryng. 31, 7–10 (1969)
Förster, A.: Experimentelle Untersuchungen über VerÄnderungen an den Atmungsorganen bei plötzlicher Einwirkung hoher Temperaturen. Dtsch. Z. ges. gerichtl. Med. 20, 445–460 (1933)
Foley, F.D., Moncrief, J.A., Mason, A.D.: Pathology of the lung in fatally burned patients. Ann. Surg. 167, 251–264 (1968)
Goldbach, H.-J.: Gibt es vitale Reaktionen der Lunge nach Hei\lufteinatmung? Dtsch. Z. ges. gerichtl. Med. 45, 394–400 (1956)
Hagedorn, M., Pfrieme, B., Mittermayer, Ch., Sandritter, W.: Intravitale und pathologisch-anatomische Beobachtungen beim Verbrennungsschock des Kaninchens. Beitr. Path. 115, 398–409 (1975)
Hardaway, R.M.: Syndromes of disseminated intravascular coagulation. Springfield: Charles C. Thomas 1966
Lasch, H.G., Róka, L., Heene, D.: The defibrination syndrome. Thrombos. Diathes. haemorrh. (Stuttg.) Suppl. 20, 97–105 (1966)
Mallory, T.B., Brickley, W.J.: Management of the Cocoanut Grove Burns at the Massachusetts General Hospital. Pathology: with special reference to the pulmonary lesions. Ann. Surg. 117, 865–884 (1943)
Mittermayer, C., Vogel, W., Burchadi, H., Birzle, H., Wiemers, K., Sandritter, W.: Pulmonale Mikrothrombosierung als Ursache der respiratorischen Insuffizienz bei Verbrauchskoagulopathie (Schock-Lunge). Dtsch. med. Wschr. 95, 1999–2002 (1970)
Moritz, A.R., Henriques, F.C., Mc Lean, R.: The effects of inhealed heat on the air passages and lungs. Am. J. Path. 21, 311–331 (1945)
Remmele, W., Goebel, U.: Zur pathologischen Anatomie des Kreislaufschocks beim Menschen. V. Pathomorphologie der Schocklunge. Klin. Wschr. 51, 25–36 (1973)
Sandritter, W., Lasch, H.: Pathologic aspects of shock. Meth. Achievm. exp. Path. 3, 86–121 (1967)
Sochor, F.M., Mallory, G.K.: Lung lesions in patients dying of burns. Arch. Pathol. 75, 303–308 (1963)
Wolf, H., Neuhof, H.: Die sogenannte Schocklunge bei akuter Verbrühung. Med. Welt 26, 1775–1776 (1975)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Brinkmann, B., Püschel, K. Heat injuries to the respiratory system. Virchows Arch. A Path. Anat. and Histol. 379, 299–311 (1978). https://doi.org/10.1007/BF00464473
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00464473