Abstract
I. Pathological study of autopsy cases with liver diseases.
Thirty-four cases out of 56 cases with liver or biliary tract disease were complicated with gastrointestinal hemorrhage as autopsy findings. Eighty-four per cent of patients with liver cirrhosis were complicated with gastrointestinal hemorrhage (Table 1), however the site of bleeding could not be identified in almost all cases, except one case with bleeding from esophageal varices and another case with bleeding from gastric and duodenal ulcers. The bleedings from gastric ulcers were recognized in 8 cases and 2 cases with bleedings from esophageal varices were observed in 13 cases of hepatoma associated with liver cirrhosis (Table 2).
From these observations, it seems that the identification of the bleeding site is very difficult in many cases with liver cirrhosis, and also difficult to find out the confirmation of bleeding from esophageal varices, even if the presence of varices have been identified in cases (Table 2). Therefore, it is important many to recognize the abnormality of blood coagulation in patients with liver diseases.
II. Interrelation between coagulation factors and proteases.
In chronic liver diseases including 17 cases with chronic hepatitis, 4 cases with pre-cirrhosis and 23 cases with liver cirrhosis, good correlation between Hepaplastintest and ICGK (r=0. 466, p<0.01), Cholinesterase (r=0.463, p<0.001), Albumin (r=0.366, p<0.02) and Total Bilirubin (r=-0.450, p<0.01) were observed (Table 3). There was no significant correlation between Hepaplastintest and Albumin content, however slight correlation between Hepaplastintest and GOT was observed in cases with chronic hepatitis. The different mechanism of reduction of coagulation factors might be considered between chronic hepatitis and liver cirrhosis.
In cases with liver cirrhosis, no alternation of fibrinogen contents were observed and Streptokinase activated Plasmin activity were decreased and also contents of C3 and C4 were diminished. There was significant correlation between Hepaplastintest and contents of C3 in chronic liver diseases (Table 4).
