Disseminated intravascular coagulation (DIC) in the intestinal circulation by acute portal vein occlusion and the effectiveness of portal-venous bypass using an antithrombogenic catheter.
The changes in blood coagulation/fibrinolysis and intestinal microvasculature after acute portal vein occlusion were studied in adult mongrel dogs. All five dogs that underwent portal vein ligation with resultant portal system thrombosis died within 81-130 min following the procedure. Fibrin deposition occurred in the small-intestine mucous-membrane capillaries within 10 min after ligation. Before ligation, high levels of tissue plasminogen activator activity were noted in small vessels, mainly those of the small-intestine submucosa. However, this activity decreased significantly after portal vein ligation, suggesting progression into irreversible disseminated intravascular coagulation. After simultaneous portal vein and superior mesenteric artery occlusion, similar changes occurred, but later than with portal vein ligation alone. The five dogs who underwent this procedure died within 70-195 min. However, if portal blood was bypassed into the femoral vein through an anti-thrombogenic heparinized hydrophilic catheter, deterioration after complete portal vein ligation was not observed; the five dogs that underwent this procedure survived.
Department of Surgery II, Nagoya University School of Medicine, Japan.
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Nakao
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Takagi
D000818:Animals; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D004285:Dogs; D005268:Femoral Vein; D005342:Fibrinolysis; D007421:Intestine, Small / Q000098:blood supply*; D008026:Ligation; D017538:Mesenteric Artery, Superior / Q000502:physiology; D011168:Portal System / Q000502:physiology; D011169:Portal Vein / Q000502:physiology*; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D013152:Splanchnic Circulation / Q000502:physiology*; D013927:Thrombosis / Q000517:prevention & control*; D010959:Tissue Plasminogen Activator / Q000502:physiology
D010959:Tissue Plasminogen Activator