Disseminated intravascular coagulation (DIC)

Abstract

Twenty cases of DIC are described: 7 connected with labor, 3 after pulmonary surgery, 2 after prostate surgery (hypertrophy), 1 after orthopedic surgery (hip joint), 1 during extracorporeal dialysis in a case of subacute glomerulonephritis, 1 in pulmonary tuberculosis with amyloidosis, 1 in bronchial cancer with metastases, 1 in a chorio-epithelioma in a man, 1 in liver cirrhosis and 2 in neonates with the hyaline membrane syndrome. Thrombosis of peripheral vessels was most frequently found in the lungs, kidneys, and the fatty tissue. Capillary thrombosis appeared quite frequently in the liver, brain, and gastric wall, and rather sporadically in the heart muscle, spleen, adrenal glands, bone marrow, and choroid plexus. Capillary thrombi are readily noticed in fatty tissue. Inspection of the subdermal fat at autopsy is useful, apart from other methods, for the diagnosis of intravital DIC. The initial occurrence of thrombosis in the capillaries of the lungs and kidney is connected with an additional effect, namely an increased blood viscosity. The absence of capillary thromboses in the myocardium can possibly be explained by the constant contractions of the heart. Because fibrin dissolves autolytically after death, one should perform autopsy as quickly as possible post mortem.