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An Example of Thrombohemorrhagic Disease

Reuben Mokotoff, MD; Leonard S. Weiss, MD; Leonard H. Brandon, MD; Michael F. Camillo, MD

Arch Intern Med. 1967;119(4):375-380.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

A MULTIPAROUS toxemic postpartum patient sustained a subcapsular hemorrhage of the liver with rupture and shock and survived following a laparotomy. In reviewing the literature on the clinical aspects of 35 cases, we found that this is the sixth patient who survived. A liver biopsy showing hemorrhagic necrosis and periportal fibrin precipitation, and the clinical course and laboratory data presented below suggests that this is an example of disseminated intravascular coagulation as postulated by McKay.¹ The role of fibrinolysis as a consequence of coagulopathy was not assessed.

The clinical history and findings in the reported cases^2-13 have a striking similarity. Hence, a syndrome is recognizable, and a preoperative diagnosis can be made. Given a multipara, usually in her thirties, with toxemia of pregnancy who develops severe pain of the right upper quadrant with vomiting and profound shock, without external blood loss, a diagnosis of subcapsular hemorrhage of the . . . [Full Text PDF of this Article]

Author Affiliations
Middletown, NY

From the departments of medicine (Dr. Mokotoff), obstetrics (Drs. Weiss and Brandon), and surgery (Dr. Camillo), Elizabeth A. Horton Memorial Hospital, Middletown.

Footnotes
Received for publication May 19, 1966; accepted Dec 7.

Reprint requests to 113 Highland Ave, Middletown, NY 10941 (Dr. Mokotoff).

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