Related Experiment Videos
Coagulopathy induced by aortoiliac aneurysms
1Department of Surgery, Royal Victoria Hospital, McGill University, Montreal, PQ.
Insights
Diffuse intravascular coagulopathy (DIC), a bleeding disorder, rarely occurs with aortic aneurysms. Prompt diagnosis and surgical repair of the aneurysm are crucial for managing this complex condition.
Area of Science:
- Vascular Surgery
- Hematology
Background:
- Diffuse intravascular coagulopathy (DIC) is infrequently associated with aortic aneurysms.
- The coexistence of DIC and aortic aneurysms presents a significant clinical challenge requiring integrated medical and surgical management.
Observation:
- Two cases of coagulopathy linked to aortoiliac aneurysms are presented, illustrating the diverse clinical presentations.
- Clinical examination should include assessment for hematomas and ecchymoses.
Findings:
- Laboratory evaluation for DIC involves measuring fibrinogen, platelet counts, fibrin degradation products, prothrombin time, and partial thromboplastin time.
- Arteriography is a key diagnostic tool, with post-procedure monitoring for bleeding at puncture sites essential.
Implications:
- The primary treatment for DIC is the removal of the underlying cause, in this case, the aortic aneurysm.
- Surgical repair necessitates meticulous hemostasis and consideration of high-speed autotransfusion to manage significant blood loss.
Abstract:
Diffuse intravascular coagulopathy (DIC) or consumptive coagulopathy is infrequently associated with aortic aneurysms. When the two coexist, they create a difficult clinical problem that requires optimal medical and surgical care. Two cases of coagulopathy associated with aortoiliac aneurysm are presented to exemplify the broad clinical picture that can be present. The definitive treatment of DIC is removal of the underlying cause. The following recommendations are made for the management of patients with aortic aneurysms and possible coagulopathy: preoperatively examine the patient for hematomas and ecchymoses; measure levels of fibrinogen, platelets and fibrin degradation products and the prothrombin and partial thromboplastin times; perform arteriography and check puncture sites for spontaneous bleeding afterwards; at aneurysm repair ensure meticulous hemostasis and compensate for excessive blood loss by high-speed autotransfusion.