J.Jpn. Surg. Soc.. 84(9): 860-864, 1983

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Report on the annual meeting

A CLINICAL STUDY ON SURGICAL PATIENTS WITH DISSEMINATED INTRAVASCULAR COAGULATION: WITH SPECIAL REFERENCE TO THE OCCURRENCE OF MAJOR ORGAN FAILURES

Among 113 consecutive patients with disseminated intravascular coagulation (DIC), twenty cases who developed this condition under surgical intervention are the subject of this study. At the onset of DIC, fourteen cases were suffered from severe infection. Coagulation study in these patients revealed decreased platelet counts and prolonged prothrombin time. There was marked increase in fibrinogen degradation products and positive ethanol gelation test was frequently observed. These fmdings were analogous to those found in the more chronic presentations of DIC in the patients with neoplastic diseases, however, plasma concentration of fibrinogen was normal. Antithrombin III level was extremely low in the patients with surgical DIC.
The patients with DIC in surgery took acute or subacute courses with very high incidence of major organ failure. The patients with dysfunction of more than three organs were seen in eight of 20 cases. The lungs, kidneys, liver and gastrointestinal tracts were involved in the descending order of frequency. Fourteen patients died and six of these were autopsied. All had multiple fibrin thrombi in more than two organs. The numbers and sites of microthrombi in the major organs were well matched with the clinical manifestations. These results suggested that DIC might be one of the precipitating factors of multiple organ failure.

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