Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Plasma fibronectin was determined in 121 normal adults and in 149 patients. Fibronectin levels in normals were strongly influenced by sex and age. The mean value of the protein in cancer patients did not differ from that in normal controls; however, patients with cryofibrinogenaemia or extensive liver metastases had lower values whereas those with obstructive jaundice due to pancreatic carcinoma had higher values than normal controls. Fibronectin levels were greatly increased in patients with primary biliary cirrhosis and moderately elevated in nephrotic syndrome. In patients with severe infection or sepsis, plasma fibronectin did not show a consistent pattern. Patients with overt disseminated intravascular coagulation, irrespective of its cause, had the lowest plasma fibronectin concentrations.
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PMID:Plasma fibronectin in normal subjects and in various disease states. 725 92

Implantation of self-expandable metal stents was planned for 21 patients (12 women, 9 men; mean age 64.7 +/- 11.6 [38-80] years) with malignant obstructive jaundice due to complex hilar biliary obstruction (Bismuth II: n = 5, Bismuth III: n = 13, Bismuth IV: n = 1, state after hepaticojejunostomy: n = 2). Stents were implanted bilaterally in 18 patients (one each on the right and left, n = 12; two stents on right, one stent on left, n = 6), one patient had three stents on one side, another had one unilateral stent. Thus there was a 93.3% success rate (46 of 49 planned stent implantations). The mean bilirubin level fell from 14.7 +/- 7.7 mg/dl before stent implantation to 3.9 +/- 5.4 mg/dl afterwards (P = 0.0001). One patient experienced late bleeding with haemorrhagic shock and consumption coagulopathy after a failed drainage attempt. She died despite superselective embolization, operative suturing of the puncture site, and wide-ranging intensive care measures. Procedure-related death rate was thus 4.8%, the 30-day death rate 9.5%. During the follow-up period, averaging 145 +/- 152 (16-529) days, jaundice recurred in six patients (30%) and was successfully treated by re-intervention in five. 13 patients died after a mean survival time of 98 +/- 119 (16-432) days. It is concluded from these data that self-expandable metal stents provide minimally invasive palliative treatment of complex biliary hilar obstruction in the type of case in which plastic stents are known to fail.
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PMID:[Palliative therapy of complex hilar biliary obstructions using self-expanding metal stents]. 750 28

An autopsy case of pseudosarcoma in the common bile duct is reported. An 82-year-old Japanese male complaining of jaundice was admitted to our hospital; he was examined by abdominal ultrasonography (US), revealing biliary calculus, dilatation of the common bile duct, and choledocholithiasis, considered to be the possible cause of the obstructive jaundice. Endoscopic retrograde biliary drainage (ERBD) and cholangioscopy were performed concurrently, revealing a vaguely whitish tumor near the papilla of Vater. Two months later, the patient died from complications of the liver, infection, and disseminated intravascular coagulation (DIC). An autopsy study revealed tumor cells with extreme pleomorphic changes, growing diffusely, very like sarcoma. Further examination revealed epithelioid arrangements in the metastatic lymph node. Twelve kinds of immunohistochemical examination showed a positive reaction, reflecting the presence of an epithelioid cytoskeleton. Of 28 cases of true and pseudosarcoma of the biliary system reported in the Japanese literature, only 1 case was reported, in 1990, to involve the common bile duct. We therefore report the present case of pseudosarcoma of the common bile duct.
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PMID:An autopsy case of pseudosarcoma of the common bile duct. 795 67

Non-operative methods to treat obstructive jaundice and cholangitis caused by cholelithiasis are endoscopic and percutaneous biliary drainage. Usually, endoscopic papillotomy and stone removal by basket catheter is available for treating choledocholithiasis. It is necessary to place a drainage catheter into the bile duct in patients who have severe cholangitis or remaining stones. On the other hand, percutaneous biliary drainage is useful in case of emergency and in patients reconstructed by the Billroth II method. Biliary drainage is necessary to treat severe cholangitis as soon as possible, for it sometimes causes endotoxin shock, disseminated intravascular coagulation (DIC) and multiple organ failure (MOF).
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PMID:[Non-surgical biliary drainage for cholelithiasis]. 836 6

A 4-month-old boy with benign hemangioma of the porta hepatis is described. Obstructive jaundice and consumption coagulopathy developed, which were treated by percutaneous transhepatic drainage (PTHD), without resection of the tumor or bypass surgery. Because of tumor regression, the patient has remained free of symptoms even after the PTHD tube was removed. Because juvenile hemangioma is a benign tumor and occasional spontaneous regression is known to occur (as in our case and other reports), it is suggested that complete resection or bypass surgery is not necessary for juvenile hemangioendothelioma, even with obstructive jaundice, if bile drainage is adequately maintained.
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PMID:Successful management of infantile hepatic hilar hemangioendothelioma with obstructive jaundice and consumption coagulopathy. 878 96

In rats with 2-week obstructive jaundice the sensitivity to endotoxin was studied and the effect of a single dose of endotoxin on histological development in the kidney, liver and spleen was also investigated. We were tested the effect on accumulation and distribution within organs, of fibrinogen labelled with radioactive iodine I 125. We showed an increased sensitivity to endotoxin in obstructive jaundice. The cause of death in most rats was acute circulatory failure during the course of endotoxic shock, without clinical features of disseminated intravascular coagulation. In the isotope study, after endotoxin administration there was a specific dynamic increase of fibrinogen accumulation in the kidneys of rats with obstructive jaundice. We proposed, that the cause of the kidney changes during the course of obstructive jaundice could be the local activation of intrarenal coagulation.
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PMID:The role of endotoxaemia in the development of renal disorders in experimental obstructive jaundice in rats. 918 46

We describe an extremely rare case of granulocytic sarcoma of the porta hepatis causing obstructive jaundice. The patient was an 84-year-old man admitted because of obstructive jaundice. Ultrasonography (US) and computed tomography (CT) scanning of the abdomen disclosed a mass about 2.5 cm in diameter near the neck of the gallbladder, and thickening of the gallbladder wall. Based on these findings, gallbladder carcinoma was suspected. After endoscopic retrograde biliary drainage (ERBD) was performed, the jaundice resolved. However, blast cells were detected in the peripheral blood 51 days after admission, and laboratory studies disclosed acute myelocytic leukemia (AML: French-American-British [FAB] type M0). We treated him conservatively, with antibiotics and ERBD but he died of disseminated intravascular coagulation. Autopsy showed that the suspected gallbladder carcinoma was actually a granulocytic sarcoma arising in association with AML and causing obstructive jaundice. The largest tumor involved the porta hepatis. It should be kept in mind that granuloctyic sarcoma is a possible cause of obstructive jaundice, even in patients with no evidence of AML.
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PMID:An autopsy case of granulocytic sarcoma of the porta hepatis causing obstructive jaundice. 965 26

We present an autopsy case of an 83-year-old Japanese man with a mucin-producing adenocarcinoma accompanied by pancreatolithiasis in the head of the pancreas. He suffered from obstructive jaundice and died of disseminated intravascular coagulation. He did not normally drink alcohol and had no history of chronic pancreatitis. The autopsy findings revealed a mucinous cystic tumor, composed of multiple dilatated branches, in the head of the pancreas. Histological examinations showed papillary adenocarcinoma, which scirrhously infiltrated the distal common bile duct with perineural invasion and lymph node involvement. He was thus diagnosed to have mucin-producing branch-type cancer in the head of the pancreas. The main pancreatic duct was dilated, and the residual pancreatic tissue showed moderate fibrosis and parenchymal atrophy. A stone was observed in a dilated branch of the primary lesion. To the best of our knowledge, there have only been five previously reported cases of mucin-producing tumor associated with pancreatolithiasis. Intraductal calcification is a major characteristic of chronic pancreatitis, but it is clinically important not to misdiagnose cancers associated with pancreatolithiasis such as chronic pancreatitis.
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PMID:Pancreatic mucin-producing adenocarcinoma associated with a pancreatic stone: report of a case. 987 45

Many complications frequently occur in gastric cancer patients which require urgent treatment. Oncologic emergencies in gastric cancer vary widely and include hemorrhage, perforation and obstruction due to gastric cancer tumors, obstructive jaundice, hydronephrosis, intestinal obstruction and disseminated intravascular coagulation due to advanced metastatic, recurrent, or systemic tumors, and adverse effects secondary to chemotherapy. In gastric cancer treatment, we must recognize the occurrence of oncologic emergencies resulting from gastric cancer progression and recurrence. It is important that the knowledge of advanced stages and the prognosis of gastric cancer patients be taken into consideration when treating patients in a critical state.
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PMID:[Oncologic emergencies in gastric cancer patients]. 1511 89

Liver involvement is common in advanced stages of Hodgkin's disease. However, only a small percentage of patients with Hodgkin's disease develops jaundice due to several causes. Vanishing bile duct syndrome secondary to Hodgkin's disease is a rare cause of cholestasis in these patients. Only 20 cases, to our knowledge, have been reported so far in adults. We report a case of Hodgkin's disease presenting with obstructive jaundice without detectable liver involvement. Liver biopsies revealed intrahepatic cholestasis and ductopenia. Although the patient was given chemotherapy, he died of sepsis and disseminated intravascular coagulation after 24 weeks of admission to hospital.
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PMID:Cholestatic liver disease with ductopenia (vanishing bile duct syndrome) in Hodgkin's disease: report of a case. 1565 42


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