J.Jpn. Surg. Soc.. 83(9): 1141-1144, 1982

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Report on the annual meeting

THE ROLE OF DIC IN MULTIPLE ORGAN FAILURE AFTER GASTROENTEROLOGICAL SURGERY

We reviewed 16 records of death cases with perforated peritonitis or leakage of gastrointestinal anastomoses at the Second Department of Surgery, Toho University Hospital, from 1977 to 1981.
In this present study, multiple organ failure (MOF) occurred in all cases. Disseminated intravascular coagulation (DIC) occurred in 11 out of 16 cases. And DIC was initial organ failure in 6 out of 16 cases. According to bacterial examination, gram-negative infection occurred in 12 out of 16 cases. In DIC cases, gram-negative infection occurred in 10 out of 11 cases. Therefore closely correlationship was observed between MOF and DIC.
It was suggested that preventive administration of polyvalent protease inhibitors such as aprotinin and gabexate mesilate was useful for prevention of DIC. And antithrombin III concentration was effective for supplementary therapy against antithrombin deficiency of DIC.
Earlier diagnosis and treatment of DIC are important for prevention and clinical management of MOF.

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