Abundant experimental and clinical evidence obtained in the past four years shows that a fat-soluble substance, called by Dam vitamin K,1 conditions the formation of prothrombin by the liver.2 In obstructive jaundice at least two factors tending to depress plasma prothrombin are at work, one being damage to the liver and disturbance in its synthetic function and the other the diminished absorption of vitamin K from the intestinal tract. Bile salts have been shown to be necessary for the absorption of fat-soluble substances from the intestinal canal,3 and in obstructive jaundice the bile delivered into the duodenum may be deficient in bile salts as well as in total volume. Another factor of importance in lowering plasma prothrombin in patients with obstructive jaundice is loss of appetite with inadequate intake of foods containing vitamin K.
The data presented in this report were obtained in the management of cases
STEWART JD, ROURKE GM. CONTROL OF PROTHROMBIN DEFICIENCY IN OBSTRUCTIVE JAUNDICE: BY USE OF VITAMIN K. JAMA. 1939;113(25):2223–2227. doi:10.1001/jama.1939.02800500029007
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: