Adrian MarstonBMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i3503 (Published 23 June 2016) Cite this as: BMJ 2016;353:i3503
- Anne Gulland
It was an unsuccessful operation early in his career that was the catalyst for Adrian Marston’s interest in intestinal circulation. As a young house surgeon at Putney Hospital he was called to see a 45 year old woman with abdominal pain. He suspected a mesenteric embolus and, when he and the senior surgeon opened the patient up, they found her small intestine still and pulseless. They realised that little could be done for her and she later died.
The Bowel in Shock
The post mortem showed that the small intestine was swollen but healthy, with no signs of necrosis or perforation. “Why did this unfortunate woman die so soon?” wondered Marston. “I thought no more of the matter at the time but this particular patient and her tragic death stuck in my mind,” he later wrote.1
A few years later he operated on a patient with an ischaemic stricture of the colon whose case he wrote up in the British Journal of Surgery. This led to a review of the literature on intestinal ischaemia, which became a paper titled The Bowel in Shock.2 Marston inherited his novelist father’s flair for …