[Disseminated intravenous coagulation in acute necrotizing pancreatitis]

The coagulation changes observed in acute pancreatitis were studied clinically and those changes observed in acute experimental pancreatitis were compared with those after the intravenous infusion of pancreatic juice and ascitic fluid exudate obtained from bile-induced pancreatitis in dogs. The coagulation changes observed in six among 37 patients with acute pancreatitis and half of them died. Those changes observed clinically were either hypercoagulability or hypocoagulability. The coagulation changes after trypsin-induced acute experimental pancreatitis, elastase and autologous bile showed an indication of consumption coagulopathy. The effect upon blood coagulation after the intravenous injection of pancreatic juice included decreased platelet counts and plasma fibrinogen levels, prolonged partial thromboplastin and prothrombin time. The intravenous injection of pancreatic exudate produced greater changes than did those of an equal amounts of pancreatic juice. There was a shortening of E.L.T. and a marked increase in F.D.P. pancreatic exudate which accumulated during acute pancreatitis may contains a toxic substance or substances which contribute to the consumption of coagulation factors.