• Title/Summary/Keyword: Disseminated intravascular coagulation

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A Fatal Intracerebral Hemorrhage Complicated by Compartment Syndrome of the Upper Arm (상지 구획 증후군 이후 발생한 치명적인 뇌출혈)

  • Han, In-Bo;Chung, Young-Sun;Shin, Dong Eun;Huh, Ryoong;Chung, Sang-Sup;Ahn, Jung-Yong
    • Journal of Trauma and Injury
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    • v.19 no.2
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    • pp.178-182
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    • 2006
  • Compartment syndrome has a wide spectrum from muscle pain to a life- threatening condition, such as acute renal failure and disseminated intravascular coagulation (DIC). Intracerebral hemorrhage (ICH) due to compartment syndrome has not been reported. We report a patient who presented with ICH leading to death. A 25-year-old female with no significant past history developed extensive compartment syndrome followed by rhabdomyolysis, acute renal failure, DIC, and ICH. Although the patient underwent a fasciotomy and hemodialysis and received aggressive resuscitation with massive transfusions of blood and intravenous fluids, she died. This case stresses the importance of early diagnosis and prompt treatment of compartment syndrome to prevent devastating complications.

Two Cases of Disseminated Intravascular Coagulation (DIC) Following Pit Viper Envenomation (살모사 교상 후 발생한 범발성 혈관내 응고장애 2례)

  • Kim, Suk-Hwan;Choi, Se-Min;Oh, Young-Min;Park, Kyu-Nam;Lee, Won-Jae;Choi, Kyung-Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.2
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    • pp.137-142
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    • 2006
  • Our records include two cases of DIC in snakebite patients. One patient, who was 48-years old, was bitten in his left ankle 3 days before admission to our hospital. Initial symptoms were painful swelling, extensive ecchymosis, and persistent bleeding at the bite site. He visited and was admitted to a local hospital, but his condition did not improve with supportive care that included a single dose of antivenin. He was transferred to our hospital. His condition was compatible with DIC. We tried multi-dose antivenin therapy and blood product transfusion. At the seventh hospital day, the patient's symptoms were completely resolved. The other patient, who was 75 years old, was bitten in his right thumb. Initial symptoms were painful swelling of the right arm and persistent bleeding at the bite site, and within minutes of hospital admission, the patient experienced massive hematochezia. We peformed laboratory tests, the results of which were compatible with DIC, and the next day a sigmoidscopic examination showed ischemic colitis. We administered multi-dose antivenin therapy and blood product tranfusion. At the third hospital day mild anemia still existed, but the patient's clinical condition was improved. No signs or symptoms of gastrointestinal bleeding were observed. In these two cases, multi-dose antivenin therapy and transfusion effectively resolved symptoms of DIC. Platelet concentrate transfusion was required only for acute thrombocytopenia. After resolution of DIC, platelet counts were returned to normal ranges within a few days. The authors propose that multidose antivenin therapy and coagulation factor transfusion might be useful for improving coagulopathy in snakebite patients.

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A Premature Newborn with Congenital Syphilis (미숙아에 발생한 선천성 매독 1 예)

  • Hwang, In-Ok;Lee, Eun-Sil
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.333-338
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    • 2007
  • A preterm newborn affected by congenital syphilis, born to mother not treated during pregnancy is described. The clinical picture was characterized by respiratory distress, cutaneous manifestations, massive hepatosplenomegaly, severe anemia, thrombocytopenia, disseminated intravascular coagulation syndrome and hypoalbuminemia. The patient was treated with daily injections of 190,500 units of crystalline penicillin G for 14 days. Premature infants with these symptoms and signs should be evaluated for congenital syphilis.

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Temporary Closure for Sternotomy in Patient with Massive Transfusion Might Be Lethal

  • Kim, Maru;Kim, Joongsuck;Kim, Sung Jeep;Cho, Hang Joo
    • Journal of Trauma and Injury
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    • v.30 no.1
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    • pp.12-15
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    • 2017
  • A 58-year-old male visited our emergency room for multiple traumas from explosion. On initial evaluation, hemopneumoperitoneum with liver laceration (grade 4) and colon perforation was identified. Hemopericardium with cardiac tamponade was also identified. Shrapnel was detected in the right ventricle. Damage control surgery was planned due to condition of hypotension. In operation room, control over bleeding was achieved after sternotomy, pericardiotomy, and laparotomy. Massive transfusion was done during operation. After gauze packing, operation was terminated with temporary closure (TC). Sanguineous fluid was drained profusely. Disseminated intravascular coagulopathy was confirmed through laboratory findings. No extravasation was discovered at hepatic angiogram. On re-operation, there was no active bleeding but oozing from sternotomy site was identified. Bone bleeding was impossible to control. Finally, reoperation was ended after gauze packing and TC all over again. The patient could survive for only a day after re-operation.

Effects of Silsosangami-extract and Its Seven Herbs on Endotoxin-induced Experimental Thrombosis in Rats

  • Ahan, Jong-Chan;Kim, Jae-Woo;Park, Won-Hwan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.1
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    • pp.218-223
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    • 2005
  • According to the Chinese and Korean medicinal and herbal literature, SSG(Silsosangami) is effective for the treatment of inflammation, hyperlipemia and arteriosclerosis. The pharmacological action of SSG has been limitedly studied in regard to ischemic infarction. This herbal medicine has been shown to express diverse activities such as immunomodulating, anti-infarction, anti-allergic and anti-inflammatory effects. Antisclerotic effects of SSG in experimentally induced atherosclerosis in rabbits have also been reported. However, pharmacological mechanisms of SSG on lipid metabolism and atherosclerosis formation are poorly understood. The present paper reports the effect of extracts obtained from SSG on endotoxin-induced experimental DIC in rats. Also, these were tested for their effect on endotoxin-induced blood platelet aggregation, thrombin-induced conversion of fibrinogen and fibrinolysis in vitro experiments with aspirin as a positive agent. The anti-thrombic properties of SSG were also investigated by means of analytical parameters of bood composition. The extracts of SSG and its seven herbs, except Cnidii Rhizoma and Carthami Flos, inhibited the endotoxin-induced DIC and thrombosis in rats. Also the extract inhibited the endotoxin-induced decrease in blood platelets and fibrinogen, and endotoxin-induced increase in fibrin degradation products (FDP) on disseminated intravascular coagulation in normal rats.

A Case of Idiopathic Hypereosinophilic Syndrome Complicated with Pulmonary Thromboembolism and Disseminated Intravascular Coagulation (폐색전증과 파종성혈관내응고가 합병된 특발성 과호산구 증후군 1례)

  • Lee, Jong Sung;Lee, Hyun-Kyung;Lee, Sung Soon;Jin, Jae Yong;Lee, Young Min;Lee, Hyuk Pyo;Kim, Joo In;Ku, Bon Il;Choi, Soo Jeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.6
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    • pp.573-578
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    • 2004
  • The idiopathic hypereosinophilic syndrome (HES) comprises a heterogeneous group of disorders with unknown pathogenesis characterized by persistent peripheral blood and bone marrow eosinophilia. And the eosinophil infiltrates of multiple organs in HES lead to severe organ dysfunction. The disseminated intravascular coagulation (DIC) is a rare complication of HES. We have experienced a case of HES complicated with DIC and pulmonary thromboembolism. After intravenous injection of methylprednisone, blood eosinophil count was normalized but DIC was persisted. With cortico steroid and cyclosporine therapy, the disease activity was favorably remitted.

A Case of Diffuse Alveolar Hemorrhage Complicated by HELLP (Hemolysis, Elevated Liver Enzymes, and Low Platelets) Syndrome (HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome에 합병된 미만성 폐포출혈 1예)

  • Jeong, Woo Jin;Huh, Jin Won;Yu, Mi Hyun;Choi, Young Jun;Jeon, Min Hyok;Sim, Jae Yun;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.418-422
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    • 2005
  • A diffuse alveolar hemorrhage (DAH) is a distinct form of pulmonary hemorrhage that originates from the pulmonary microcirculation. Disseminated intravascular coagulation (DIC) is one cause of DAH. Although HELLP syndrome associated with DIC can cause DAH, there are no published case reports that the authors are aware of. We report the case of a pregnant woman with HELLP syndrome who developed DAH. Because pregnant women with HELLP syndrome can develop DAH as a form of ARDS, a bronchoalveolar lavage may be used to make a differential diagnosis of this lung manifestation.

A Clinical Evaluation of 717 Chest Injuries (흉부외상 717례의 임상적 고찰)

  • 김희준
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.128-136
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    • 1990
  • A Clinical analysis was performed on 717 cases of the chest trauma experienced at department of thoracic and cardiovascular surgery, Soonchunhyang Chunan Hospital from Mar. 1985 to Jun. 1989. 1. The sex ratio was 2.89:1 with male predominance. The patients in 75 % of total cases was between 3rd to 5th decade. 2. The most common causes were traffic accident in non-penetrating thoracic injury and stab wound by knife in penetrating injury. 3. The hemothorax, pneumothorax and hemopneumothorax were observed in 306 cases[42.7 %]. 4. The left thorax was the preferred site of penetrating and non-penetrating thoracic injury. The rib fracture was prevalent between 4th to 8th rib. 5. The open thoracotomy was performed in 55 cases[7.7 %] 6. The overall mortality was 3.07 %[22 cases] and causes of death were hypovolemic shock, adult respiratory distress syndrome, sepsis, disseminated intravascular coagulation, renal failure and pneumonia.

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Clinical Experiences of Multiple Organ Failure after Surgery for Acquired Cardiovascular Disease

  • 김병열
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.275-284
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    • 1990
  • A serious problem after cardiovascular surgery known as Multiple Organ Failure[MOF] whereby several vital organs successively demonstrate dysfunction in spite of intensive postoperative treatment has recently arisen. We have made a retrospective study of the clinical records of 137 patients who underwent cardiovascular surgery during past two years [1987-1988]. Fourteen patients [10%] developed multi-organ failure postoperatively with the results of seven death [50%]. In fatal group, preoperative poor cardiac function [Cardiac Index<2.0L/min/m2] was considered important prognostic factor and infection 5 disseminated intravascular coagulation complicating gastrointestinal bleeding were the leading cause of death. In conclusion, evaluation of multiple factors concerning multi-organ failure demonstrates preoperative poor functional preservation of vital organs is the main factor. So early diagnosis k management for each of the failing organs & prevention of infection are mandatory of the treatment of these critically ill patients.

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