Abstract

AGRAMONTE-LLANES, Olga M et al. Chronic disseminated intravascular coagulation as the form of presentation of a case with aortic aneurysm. Rev Cubana Hematol Inmunol Hemoter [online]. 2011, vol.27, n.2, pp.252-259. ISSN 0864-0289.

The term disseminated intravascular coagulation (DIC) defines a pathological process complicating the clinical evolution of various diseases. It is caused by "procoagulants" introduced into or produced in blood circulation which may exceed natural anticoagulant mechanisms. The most common causes of the disease are infectious and tumoral. A less common cause is the presence of an aortic aneurysm, among others. Its incidence in patients with large aortic aneurysms is 0.5 -1 %. Various factors influence the emergence of these large vascular dilatations, but in elderly patients their development is closely related to atherosclerosis. A case is presented of an 88-year old patient with a background of type 2 diabetes mellitus and hypertension, who shows purpuric petechial manifestations on his abdomen and lower limbs, and has had hematuria for two months. Laboratory tests showed evidence of DIC, and imagenologic testing showed the presence of vascular lesions of aortic thoracic and abdominal location. Due to the advanced age of the patient and the underlying illnesses supporting the undryable nature of the lesions, treatment was started with heparin of low molecular weight, an important therapeutic management option for large aneurysms, particularly when they are undryable, surgical risk is high, or both. The patient's clinical evolution has been favorable, with a sustained control of coagulopathy for 2 years.

Keywords : Chronic disseminated intravascular coagulation; aneurysm; fraxiheparin.

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