The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Spontaneous Arterial Bleeding in Patients with Alcoholic Liver Cirrhosis: a Series of Three Cases

알코올 간경변 환자에서 발생한 자발성 동맥 출혈의 3예

  • 선춘식 (을지대학교 의과대학 내과학교실) ;
  • 조윤주 (을지대학교 의과대학 내과학교실) ;
  • 이지현 (을지대학교 의과대학 내과학교실) ;
  • 조영관 (을지대학교 의과대학 내과학교실) ;
  • 안상봉 (을지대학교 의과대학 내과학교실) ;
  • 손병관 (을지대학교 의과대학 내과학교실) ;
  • 조영권 (을지대학교 의과대학 영상의학과교실)
  • Received : 2014.02.27
  • Accepted : 2014.05.09
  • Published : 2014.10.01
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Abstract

Spontaneous arterial bleeding has been reported rarely. In a patient consuming heavy amounts of alcohol with alcoholic liver cirrhosis, spontaneous bleeding can be evoked by thrombocytopenia, altered platelet function, and shear stress on fully dilated arteries by portal hypertension. Alcohol consumption itself can also predispose a patient to bleeding by influencing the aggregation and activation of platelets, and altering the coagulation and fibrinolysis pathway. All of these mechanisms could cause patients with alcoholic liver cirrhosis to bleed spontaneously; however, conditions inducing peripheral arterial bleeding are very rare. Here, we report three cases of spontaneous arterial bleeding in patients with liver cirrhosis consuming heavy amounts of alcohol. All of the patients bled without any physical trauma, and the involved arteries were the intercostal arteries in two cases and a gastroduodenal artery in the other case. The patients were treated by angiographic embolization. One expired due to recurrence of arterial bleeding despite repeated angiographic embolization and massive transfusion.

Keywords

References

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Cited by

  1. Spontaneous intercostal artery bleeding in a patient with alcohol‐induced liver cirrhosis vol.9, pp.8, 2014, https://doi.org/10.1002/ccr3.4613