Coagulopathy induced by aortoiliac aneurysms

Diffuse intravascular coagulopathy (DIC) or consumptive coagulopathy is infrequently associated with aortic aneurysms. When the two coexist, they create a difficult clinical problem that requires optimal medical and surgical care. Two cases of coagulopathy associated with aortoiliac aneurysm are presented to exemplify the broad clinical picture that can be present. The definitive treatment of DIC is removal of the underlying cause. The following recommendations are made for the management of patients with aortic aneurysms and possible coagulopathy: preoperatively examine the patient for hematomas and ecchymoses; measure levels of fibrinogen, platelets and fibrin degradation products and the prothrombin and partial thromboplastin times; perform arteriography and check puncture sites for spontaneous bleeding afterwards; at aneurysm repair ensure meticulous hemostasis and compensate for excessive blood loss by high-speed autotransfusion.