Case study Essay Example | Topics and Well Written Essays - 1500 words - 4

Case study - Essay Example Even though he was registering a good recovery following his multi-organ surgery in the lungs, kidneys, liver and splenectomy in the high-dependency unit, from the sixth postoperative day, he began to deteriorate, and this called for investigations about the possible aetiology of his sudden deterioration despite initial evidence of recovery. The potential risk factors for his deterioration are multiple bony traumas; multi-organ injuries and surgeries including lungs, liver, kidneys, and spleen; multiple blood transfusions; and hospital-acquired infection in the high-dependency unit. The provisional diagnosis could be one of acquired coagulopathy that may have resulted due to the above risk factors. The provisional diagnosis could be DIC or disseminated intravascular coagulation since the most common signs of this disorder are petechiae, ecchymosis, and oozing from venipuncture sites and catheter sites, as well as bleeding from surgical incisions (Attar et al., 1969, p. 939-965). In some situations, DIC becomes only evident after laboratory analysis with mild or no clinical symptoms at all. As in this case, these patients become symptomatic after stress situations, such as, surgery, or severe infections. The common denominator of DIC is the pathological generation of thrombin, which leads to widespread intravascular depo sition of fibrin and to the consumption of coagulation factors and platelets. DIC is as such not a disease entity, but the consequence of a variety of disorders that diffusely lead to the activation of coagulation mechanisms within the bloodstream (Carey and Rodgers, 1998, 65-73). The formation of thrombi in the microcirculation activates the fibrinolytic process as a compensatory mechanism to lyse the clots. This mechanism generates circulating fibrin degradation products, which in concert with the coagulation deficiencies and thrombocytopenia results in bleeding. DIC occurs in a wide spectrum of diseases.