Clinical Studies of Hemorrhagic Diathesis in Liver Diseases

Abstract

Hemorrhagic diathesis was investiqated in 147 cases consisting of 12 acute hepatitis, 22 chronic hepatitis, inactive form, 27 chronic hepatitis, active form, 43 liver cirrhosis, 7 cholecystopathy and 36 other miscellaeous hepato-biliary diseases.
Eight labolatory tests detecting bleeding tendency were performed: bleeding time clotting time, clot retraction, Rumpel-Leede phenomenon, platelet count, thrombotest, normotest and plasma prothrombin time. Bleeding time longer than 5min. was observed in 46 out of 120 (33%) cases, clotting time longer than 15min.; in 1 out of 140 (1%), incomplete clot retraction; in 29 out of 132 (22%), over two positive Rumpel-Leede phenomenon; in 24 out of 136 (18%), platelet count less than 120, 000; in 34 out of 146 (23%), thrombotest less than 70%; in 85 out of 135 (63%), normotest less than 70%; in 35 out of 70 (50%) and plasma plothrombin time longer than 15sec.; in 27 out of 137 (20%).
In liver cirrhosis, following tests showed abnormal values more often than in other diseases: Rumpel-Leede phenomenon (14 out of 41 (34%) cirrhosis, 10 out of 95 (11%) other diseases), platelet count (20 out of 43 (47%), 14 out of 103 (14%)), thrombotest (35 out of 41 (85%), 50 out of 94 (53%)), normotest (24 out of 28 (86%), 11 out of 42 (26%)), and plasma prothrombin time (19 out of 42 (45%), 8 out of 95 (8%)). Clot retraction is one of the most reliable test to avoid the bleeding after liver biopsy. There is no difference, however, in various liver diseases of the impaired retractions rates.
Hemorrhagic diathesis was often observed in acute hepatitis and chronic hepatitis as well as in liver cirrhosis. Therefore, previous to peritoneoscopy and liver biopsy, it is necessary to check hemorrhagic diathesis. And if there is bleeding tendency, it should be treated beforehand.