Description
Clinical History
A 77-year old male presented with a 3-day history of abdominal and flank pain with fevers and rigors. He was 2 weeks post-operative from a duodenal ulcer repair surgery. He was hypotensive, hyperkalemic and hyponatremic with a purpuric rash. His blood cultures grew Escherichia coli. He failed to respond to treatment, and died soon after admission due to septic shock.
Pathology
The combined kidney and adrenal gland have been mounted, in order to display the cut surfaces. Extensive hemorrhage has occurred into the adrenal medulla, and there is some extravasation of blood into the periadrenal fat. This is an example of adrenal hemorrhage in the setting of severe septic shock also known as ‘Waterhouse-Friderichsen syndrome.
Further Information
Waterhouse-Friderichsen syndrome is characterized by adrenal hemorrhage cause by overwhelming sepsis leading to hypotensive shock, disseminated intravascular coagulation (DIC) and adrenocortical insufficiency. It most commonly occurs in children and rarely in adults. Neisseria meningitis causes over 80% of cases of adrenal hemorrhage. Other organisms that may cause it include Streptococcus pneumoniae, pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae and staphylococci.
The exact cause of the hemorrhage is unclear. It may be due to bacterial seeding of the adrenal vessels, to the DIC or to endothelial dysfunction from inflammatory mediators or bacterial toxins. Adrenal hemorrhages can occur bilaterally. The hemorrhage begins in the medulla and extends outwards to the cortex, and may extend into the periadrenal fat. This leads to adrenal gland failure. Patients present with rapidly progressive septic shock, diffuse purpuric skin rash and adrenal insufficiency crisis. Treatment includes supportive therapy, intravenous antibiotics directed against the cultured organisms, and steroid therapy. The mortality rate is over 50%.
Advantages
- Anatomically accurate and identical to real specimen
- No ethical issues - not real human body parts
- Reasonably priced
- Available within a short lead time
- Reproducible, several identical prints can be used as a classroom set
- Can be produced in different sizes to cater for the needs of the teacher
Human Cadavers
- Access to cadavers can be problematic. Many countries cannot access cadavers for cultural and religious reasons
- Cadavers cost a lot money
- High cost for establishing your own plastination suite
- Wet specimens cannot be used in uncertified labs
- Dissection of cadavers is a lot of staff time and that is a cost
- Storage of cadaver material needs special refrigeration etc. which has coast
- If you want another specimen you have to start all over again
Plastinates
- Costs
- Ethical issues
- Timeframe for plastination process
- Many countries do not allow their importation
- One of a kind
Superior 3D print results compared with conventional methods
- Vibrant color offering with 10 million colors
- UV-curable inkjet printing
- High quality 3D printing that can create products that are delicate, extremely precise and incredibly realistic
Clear Support Material
- To avoid breakage of fragile, thin, and delicate arteries, veins or vessels, a clear support material is printed on such spots. This makes the models robust and can be handled by students easily.
