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August 1961

Vascular Spasm and Disseminated Intravascular Coagulation: Influence of the Phenomena One on the Other

Author Affiliations

From the Surgical Research Laboratory, Martin Army Hospital, Fort Benning, Ga.; Chief, General Surgical Service, Martin Army Hospital, Fort Benning, Ga. (Dr. Hardaway); Research Laboratory, Department of Pathology, Boston Free Hospital for Women, and the Department of Pathology, Harvard Medical School, Boston (Dr. McKay), and Prespecialty Resident in General Surgery, Martin Army Hospital, Fort Benning, Ga. (Dr. Hollowell).

Arch Surg. 1961;83(2):173-180. doi:10.1001/archsurg.1961.01300140015003

Vascular surgeons are well aware that the smaller the diameter of a vessel or graft, the harder it is to prevent its thrombosis. It has been shown that intravascular coagulation in capillaries of the kidney brought on by an incompatible blood transfusion can cause acute renal failure in the dog with death in uremia and the pathological picture of lower nephron nephrosis.1,2 The thrombi cause a focal microscopic tubular necrosis due to ischemia. Hemorrhagic necrosis of the gastrointestinal mucosa was also produced by the same mechanism.3,4 These kidney lesions,1,2 as well as the hemorrhagic necrosis of the gastrointestinal mucosa,3-5 developed only if there had previously been a laparotomy with a kidney biopsy. It was postulated2-5 that kidney trauma caused a spasm of the arterioles with diminution of blood flow through the capillary bed of the kidney and other viscera. This sluggish blood was then more