184 autopsy cases with liver diseases were examined clinicopathologically with special reference to the incidence and distribution of microthrombi and classic thrombi in various organs.
Microthrombi and/or classic thrombi were found in one or more organs in 50.0% to 59.4% of the patients with various liver diseases. But only 4 among 184 patients had many microthrombi in more than three organs and the incidence of disseminated intravascular coagulation seemed to be low in autopsy cases with liver diseases. Incidence of microthrombi showed no significant difference in the groups with and without portal vein thrombosis.
Hemorrhage in the upper alimentary tracts of the patients with liver cirrhosis did not seem to develop by disseminated intravascular coagulation. Consumption of clotting factors in liver diseases seemed to occur by thrombus formation in portal vein and esophageal varices and by hemorrhage in various organs.
References
1
Bloom AL.
1975; Intravascular coagulation and the liver. British Journal of Haematology 30: 1
3
Fletcher AP,
Biederman O,
Moor D,
Alkjaersig N,
Sherry S.
1964; Abnormal plasminogen-plasmin system activity (Fibrinolysis) in patients with hepatic cirrhosis. Its cause and consequences. Journal of Clinical Investigation 43: 681
4
Hillenbrand P,
Parbhoo SP,
Jedrychowsky A,
Sherlock S.
1974; Significance of intravascular coagulation and fibrinolysis in acute hepatic failure. Gut 15: 83
6
Krauss H,
Liehr H,
Grün M,
Thiel H.
1973; Histological investigation of intravascular coagulation in rats with gradual occlusion of the portal vein. Beiträge zur pathologischen Anatomie und zur allgemeinen Pathologie 149: 84
8
Liehr H,
Grün M,
Thiel H,
Brunswig D,
Krauss H.
1972; Different stimuli to disseminated intravascular coagulation in liver diseases (Letter). Thrombosis et Diathesis Haemorrhagica 28: 325
10
Rake M,
Flute PT,
Shilkin KB,
Lewis ML,
Winch J,
Williams R.
1971; Early and intensive therapy of intravascular coagulation in acute liver failure. Lancet 4: 1215