:Part 1. With Special Reference to the Coagulation and Fibrinolytic System

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To clarify the pathogenesis of gastrointestinal bleeding in fulminant hepatitis, acute hepatic failure of rabbits induced by intravenous administration of 1g/kg D-galactosamine HCL was investigated with special reference to the coagulation and fibrinolytic system.In addition, the influence of heparin was also examined. Endotoxemia was detected early at 9th hour after galactosamine injection, and serial coagulation studies showed an occurrence of disseminated intravascular coagulation (DIC) at terminal stage prior to death in most cases. Autopsy revealed gastrointestinal erosions in 24 of 28 rabbits, 3 of which were accompanied by gastrointestinal ulcer at the stage UL II to IV; two in the gastric antrum and one in the duodenum. The gastric erosions were far more common in the fundus and corpus than in the antrum. In all 3 cases of ulcer and 2 cases of erosion numerous fibrin thrombi were recognized in the mucosa and submucosa, which suggests that these lesions were caused by severe mucosal ischemia due to microthrombosis. In the heparin-treated group, mucosal damage was significantly alleviated in the gastric corpus and fundus and the formation of ulcer and microthrombosis were prevented. These results led to the conclusion that the microcirculatory disturbances associated with DIC may play an important role in the development of gastrointestinal bleeding in acute hepatic failure. Heparin is effective for the prevention of gastrointestinal lesions when appropriately administered.
財団法人日本消化器病学会の論文

:Part 1. With Special Reference to the Coagulation and Fibrinolytic System

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