Chronic consumption coagulopathy accompanying abdominal aortic aneurysm

Each of two patients harboring a stable abdominal aortic aneurysm manifested severe recurrent bleeding consequent to chronic consumption coagulopathy (CCC). Both underwent successful aneurysmectomy, but in only one patient did bleeding cease and depressed clotting factors return to normal activity. In the other patient, subsequent observations suggested that his coagulopathy actually resulted from occult pancreatic carcinoma. We propose here criteria for establishing stable aneurysm as the cause of CCC and demonstrate the efficacy of heparin in reversing the coagulation defect prior to surgical intervention. These cases also illustrate that the discovery of CCC accompanying stable aneurysm may signal the presence of another underlying disorder.