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Cerebral involvement with disseminated intravascular coagulation in intestinal disease
Insights
Disseminated intravascular coagulation (DIC) is a serious intestinal disease complication. Early diagnosis and heparin therapy reversed DIC in one patient, highlighting the importance of recognizing cerebral involvement.
Area of Science:
- Medicine
- Pathology
- Neurology
Background:
- Disseminated intravascular coagulation (DIC) is a severe complication associated with intestinal diseases.
- Cerebral involvement is a critical, yet often overlooked, manifestation of DIC in this context.
Purpose of the Study:
- To investigate the occurrence and impact of DIC as a complication of intestinal disease.
- To highlight the significance of cerebral involvement in DIC secondary to intestinal disease.
- To evaluate the efficacy of early diagnosis and treatment for DIC.
Main Methods:
- A retrospective case series analysis was conducted over a two-and-a-half-year period.
- Clinical data, including neurological signs, were reviewed for six patients.
- Post-mortem examination of brain tissue was performed in three cases.
Main Results:
- Six patients with intestinal disease developed DIC.
- All six patients exhibited clinical evidence of cerebral involvement.
- Microscopic examination revealed small vessel thrombi in the brains of all three post-mortem cases.
- Delayed diagnosis of cerebral DIC posed significant risks.
- One patient with early diagnosis and prompt heparin therapy showed complete reversal of DIC.
Conclusions:
- Cerebral involvement is a frequent and serious complication of DIC in patients with intestinal disease.
- Timely recognition of neurological signs is crucial for early DIC diagnosis and effective management.
- Heparin therapy can successfully reverse DIC when administered early.
Abstract:
Over a two-and-a-half-year period at the Sheffield Royal Infirmary, six patients developed disseminated intravascular coagulation as a serious complication of intestinal disease. There was clinical evidence of cerebral involvement in all six patients, and small vessel thrombi were demonstrated in the brains of all three cases examined post mortem. Where the true significance of the cerebral disorder was not recognised, this led to delay in the diagnosis with serious risk to the patient. In the single case in which the diagnosis was made early, the intravascular coagulation was completely reversed with heparin therapy.