Abstract
A 73-year-old man was referred to our hospital on December 3, 1993, because of secondary hemorrhage after extraction of the right mandibular molars. In 1990, a diagnosis of dissecting aortic aneurysm (DAA) was made and he had been receiving an anticoagulant until two months previously, when he stopped taking it for no particular reason.Because local hemostatic procedures were only effective temporarily and because hematological examinations on variables, admission showed abnormal coagulation, we consulted the Third Department of Internal Medicine, Hokkaido University Medical Hospital. Coagulation tests at that department revealed low function of platelets, low values of VIII and XII factors, and high values of thrombin-antithrombin complex, plasmin-a plasmin inhibitor complex, and D-dimer. These findings fulfilled the diagnostic criteria for DIC established by the study group of the Ministry of Health and Welfare of Japan. Thus, a diagnosis of chronic DIC related to and DAA was made, because the patient's past history and family history were unremarkable, except for the DAA and a mild bleeding tendency. The local hemorrhage was well controlled after two days of oral treatment with tranexamic acid.
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