Tammy Do

1
Necrosis

• Tammy Do
• Trauma Research Associates Program
• 8.24.2012

2
Necrosis

• Premature death of cells/death of body tissue
• Apoptosis vs. Necrosis
• Caused by
• Infections
• Toxins
• Trauma
• Ischemia

3
Causes

• Ischemia
• Thrombosis/embolism
• Infection/Disease
• Fungal/bacterial
• Diabetes
• Chemicals
• Poisons/toxins
• venom
• Trauma

4
Necrotic Wound from Spider Bite
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Types of Necrosis

• Coagulative
• Liquefactive
• Caseous
• Fatty
• Fibrinoid
• Gangrenous
• Aseptic

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Coagulative Necrosis

• Caused by ischemia
• Denaturation of structural proteins
• Enzymatic digestion of cells
• Architecture of tissue preserved
• Occurs in organs like heart, spleen, kidney
• Does not occur in brain

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Liquefactive Necrosis

• Necrotic tissue digested by enzymes into liquid
• Associated with abscess formation
• Commonly seen in brain
• ischemia
• Fungal or bacterial infection
• Not in brain

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Caseous Necrosis

• Necrotic tissue is crumbly and cheese-like
• Typically caused by tuberculosis
• Syphilis
• fungal

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Fat Necrosis

• In response to trauma
• Lipases break down fats
• React with calcium saponification
• Chalky white deposits
• Most commonly seen in pancreas and breasts
• Acute pancreatitis

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Fibrinoid Necrosis

• Caused by deposition of fibrin or fibrin-like
  materials
• Vasculitis

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Gangrenous Necrosis

• Considerable mass of necrosis
• Types of gangrene
• Dry
• Wet
• Gas

• Dry Necrosis
• Form of coagulative
• Caused by ischemia
• Autoamputation
• Distal parts of limbs
• Dry, shrunken, black

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Gangrenous Cont.

• Wet
• Moist tissue and organs
• Characterized by bacterial infection
• Dark, swollen, foul odor

• Gas
• Bacterial infection that produces gas within
  tissue
• Deadly

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Gangrenous Cont.
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Aseptic Necrosis

• Avascular necrosis or osteonecrosis
• Necrosis of bone
• Lack of blood supply to bone
• Medications, trauma, ischemia, hypercoagulable
  blood, alcoholism

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Treatment

• Depends on the extent of damage
• Restoration of blood flow
• Maggot Therapy
• Debridement
• Amputation

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Sources

• http//onlinemedicinefacts.com/pathology/caseous-n
  ecrosis-liquefactive-necrosis-and-fibrinoid-necros
  is
• http//www.symptomsbook.com/Facts-Therapy-Pictures
  -Diagnosed-Information-Diagnosis-Herceptin-Treated
  -necrosis-Diagnosed-Diagnosis.htm
• http//www.medicinenet.com/aseptic_necrosis/articl
  e.htm
• http//www.nlm.nih.gov/medlineplus/ency/article/00
  2266.htm
• http//www.mayoclinic.com/health/avascular-necrosi
  s/DS00650
• http//library.med.utah.edu/WebPath/CINJHTML/CINJ0
  29.html