The Early Lesions

A disease characterized by ascites and hepatomegaly was described in Jamaica by McFarlane and Branday in 1945, and later studied by Hill and his colleagues (Hill, Rhodes, Stafford and Aub, 1953), and by Bras, Jelliffe and Stuart (1954). Bras and his co-workers demonstrated occlusion of the small hepatic veins and accordingly named the condition 'Veno-occlusive disease of the liver' (V.O.D.). The exact nature of the occlusions has not been ascertained, although Bras and his colleagues likened some of them to an obliterating endophlebitis, and others to organized mural thrombi. The death of three children early in the disease, one three days, another five days and a third 21 days after the onset of symptoms has prompted us to reinvestigate the pathogenesis of what are believed to be early lesions.