1979 Volume 20 Issue 3 Pages 308-313
A 41-year-old man, undergone the gastorectomy and splenectomy for gastric cancer 6 years ago, admitted to Seirei Hamamatsu Hospital with high fever (40°C), delirium and shock at night on April 25, 1974. Laboratory findings were as follows: blood sedimentation rate 2mm/hour; WBC 14,000 with 90% neutrophils; creatinine 4.1mg/dl; bilirubin 10.2mg/dl (direct 7.2mg/dl); SGOT 209 U; Al-phos. 39 U (King-Armstrong); prothrombin time 15.5 sec. (control 12.0 sec.); PTT 83.5 sec. (control 37.5 sec.). Microbiological examinations in blood and liquor were negative. The patient died about 26 hours after admission in the state of generalized convulsion appeared after the chills and hallucination. In the autopsy findings, there were extensive bilateral adrenal hemorrhage, scattered focal hemorrhage in the small intestine, several gall stones and small abscess near the Vater's ampulla, but no evidences of carcinoma and its metastasis. Microscopically, thrombi were found in adrenal veins, interlobular hepatic veins and portal veins. These findings support the presence of disseminated intravascular coagulation and the clinical pictures were seemed similar to those cases reported by Ratnoff and Nebehay (1962), Whitaker (1969) and Bisno et al. (1970).
