Postoperative Disseminated Intravascular Coagulation and Fibrinolysis

Celiac axis and superior mesenteric artery injury associated with left radical nephrectomy for locally advanced renal cell carcinoma

The superior mesenteric artery and celiac axis were inadvertently ligated during left radical nephrectomy for a large upper pole renal carcinoma with massive perihilar and periaortic adenopathy. Computer-generated 3-dimensional illustrations created from the computerized tomography scan demonstrated the close proximity between these visceral branches and the adenopathy mass complex, and showed how this bulky disease may interfere with surgical anatomy. When left radical nephrectomy is performed for locally advanced and/or bulky node-positive renal neoplasms, surgeons must be cognizant of the location of the major visceral arterial branches and possible anatomical distortions.

[Incidence of biological intravascular coagulation in legal induced abortions]

A prospective study was designed to evaluate coagulation abnormalities induced by early abortion (before ten weeks of pregnancy). Fifty-two women underwent suction abortion, under diazepam-fentanyl anaesthesia with spontaneous ventilation; they were screened for coagulation parameters before and after surgery. Eight tests were carried out: prothrombin time, activated partial thromboplastin time (APTT), thrombin time platelet count, fibrinogen levels, fibrin split products, fibrin soluble complexes and euglobulin lysis time. Results were consistent with activation. Consequences were limited and one general test (APTT) was not significantly modified. Suction abortion, even performed in early pregnancy, exposed to biological disseminated intravascular coagulation with a general risk of venous thrombosis.