Vascular Spasm and Disseminated Intravascular Coagulation

Abstract

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.1,2The thrombi cause a focal microscopic tubular necrosis due to ischemia. Hemorrhagic necrosis of the gastrointestinal mucosa was also produced by the same mechanism.3,4These kidney lesions,1,2as well as the hemorrhagic necrosis of the gastrointestinal mucosa,3-5developedonlyif there had previously been a laparotomy with a kidney biopsy. It was postulated2-5that 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