Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.21.6 (thromboplastin)
 13,278 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intramural hematoma of the small intestine is a relatively rare but serious complication of oral anticoagulant therapy. On the basis of a retrospective epidemiological survey the authors estimate its incidence at 1 case per 20 000 admissions to medical and surgical services or 1 case per 2500 anticoagulated patients per year. The classical trial of clinical symptoms comprises abdominal pain, small bowel obstruction and multiple hemorrhagic symptoms (hematuria, hematomas, ecchymoses, hematemesis and melaena). The most important etiologic factors appear to be overanticoagulation with vitamin K antagonists (the thromboplastin time is prolonged in over 70% of cases) or correct oral anticoagulation associated with additional impairment of hemostasis due to the administration of drugs inhibiting platelet function. Radiologic examination of the gastrointestinal tract reveals that the jejunum and the ileum are sites of predilection for intramural intestinal hematoma. The treatment of choice is conservative; surgery should be reserved for cases in which the diagnosis is doubtful and for patients who exhibit signs of bowel necrosis or peritonitis.
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PMID:[Incidence of intramural digestive system hematoma in anticoagulation. Epidemiologic study and clinical aspects of 59 cases observed in Switzerland (1970-1975)]. 660 15

Eight tests of hemostasis were measured in 233 horses with colic. Blood samples were obtained at admission and for 4 consecutive days of hospitalization. Data were analyzed retrospectively by outcome, by broad-category diagnosis group, by small intestinal disorder, and by smaller categories for comparing specific diseases. Nonsurviving horses and horses with the most severe forms of intestinal ischemia had changes interpreted as hypercoagulative, the intensity of which was increased on the first and second mornings (sample times 2 and 3) after admission, when most significant differences for results of specific tests were detected. Nonsurvivors had decreased antithrombin III activity and prolonged prothrombin and activated partial thromboplastin times; those with strangulating obstructions also had decreased protein C and plasminogen activities. During hospitalization and with survival, these changes tended to reverse. In most horses, regardless of diagnosis or outcome, concentration of fibrin degradation products and fibrinogen, and alpha 2-antiplasmin activity increased over time. Whether these changes reflected specific effects of colic or of the acute-phase response was not determined. In comparisons of small intestinal disorders (proximal enteritis, strangulations, and impactions), diagnostically distinguishing features were not found. Likewise, in comparisons of specific diseases (small vs large intestinal impaction, proximal enteritis vs colitis, small vs large intestinal obstruction), diagnostically distinguishing features were not found.
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PMID:Analysis of hemostasis in horses with colic. 840 38

An African-American man aged 65 years with multiple malignancies in remission was admitted for small bowel obstruction. He was treated with laparotomy following failure of conservative management. Postoperatively, he developed intra-abdominal bleed, which persisted, despite surgical haematoma evacuation. Further haematological workup revealed isolated prolongation of activated partial thromboplastin time (aPTT) with reduced factor VIII (FVIII) activity and raised FVIII inhibitor titre. Assuming acquired haemophilia A (AHA), FVIII inhibitor bypassing activity and corticosteroids were started with subsequent resolution of the bleeding from the surgical site. The patient remained free of bleeding episodes at 3-month follow-up and the aPTT normalised. This case report highlights the association of surgery with AHA and summarises the treatments with underlying mechanisms.
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PMID:Acquired haemophilia A: an unusual postoperative complication. 2785 79