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Morphological Bases of DIC Syndrome in the Liver with Biliary Obstruction

Received: 16 August 2021    Accepted: 14 September 2021    Published: 12 October 2021
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Abstract

Background: The development of disseminated intravascular coagulation syndrome (DIC), with liver pathologies, is usually considered a terminal condition caused by a violation of the blood coagulation system. A number of blood coagulation factors are synthesized by the liver, in this regard, the development of DIC syndrome in liver pathology is of particular importance. It is assumed that the DIC syndrome in liver pathology is caused by a violation of the coagulation properties of the blood. At the same time, local lesions of the hematocirculatory bed of the liver, as well as ultrastructural aspects of intravascular blood coagulation, remain unclear. Objective: To study the hematocirculatory bed of the liver and the features of the ultrastructure of platelet thrombi at 20-day experimental cholestasis in experimental white rats. Materials and methods: Experimental cholestasis was created in experimental rats (m=28) by ligation and transection of the common bile duct. The animals were sacrificed in compliance with ethical standards on days 10 and 20 of cholestasis. The liver tissue was examined by histological, corrosive, and electron microscopic methods. Results: Studies have shown that the development of DIC occurs with 20-day cholestasis, when biliary cirrhosis is formed in the liver. Some disorders of hemocirculation are observed at 10 days of cholestasis, in the form of erythrocyte sludge in the vessels of the liver. A pronounced disseminated intravascular coagulation syndrome manifests itself at 20 days of cholestasis. Disturbance of circulation is expressed in the interlobular branches of the portal system. Formed thrombi consist mainly of platelets with a minor admixture of erythrocytes and leukocytes. Ultrastructurally, a thrombus appears to be aggregated platelets, the structure of which is without significant changes. The elements of the hyalomer and granulomere are well detected in them. Most contain dense granules, some have undergone degranulation. A distinctive feature of a thrombus is the absence of fibrin filaments in the thrombus. Conclusion: Long-term experimental cholestasis, in some cases, is accompanied by a violation of the anticoagulant properties of the blood and contributes to the development of DIC. The morphological manifestation of which are platelet thrombi that arise in the interlobular veins. The ultrastructural features of these thrombi indicate an increase in the aggregation capacity of platelets, which, in combination with impaired hemostasis, probably contributes to the development of hemorrhage in liver pathology.

Published in International Journal of Clinical and Experimental Medical Sciences (Volume 7, Issue 5)
DOI 10.11648/j.ijcems.20210705.12
Page(s) 138-142
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Liver, Obstructive Jaundice, Intravascular Blood Coagulation, Platelet Thrombus Ultrastructure

References
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[2] Альфонсов В. В. Механизмы развития морфологического эквивалента ДВС-синдрома / В. В. Альфонсов, Е. В. Альфонсова // Тромбоз, гемостаз и реология. — 2010. — № 1. — С. 44-51. [Alfonsov V. V. Mechanisms of development of the morphological equivalent of DIC-syndrome / V. V. Alfonsov, E. V. Alfonsova // Thrombosis, hemostasis and rheology. - 2010. - No. 1. - P. 44-51].
[3] Баркаган З. С. Гемостаз. В кн.: Руководство по гематологии. Т. 3. Под редакцией А. И. Воробьева. 3-е изд., перераб. и доп. М., Ньюдиа-мед; 205. С. 9-147 [ Barkagan Z. S. Hemostasis. In the book: Guide to Hematology. Vol. 3. Edited by A. I. Vorobyov. 3rd ed., Rev. and add. M., Nudia-med; 205. p. 9-147].
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[7] Carey M. J., Rodgers G. M. Disseminated intravascular coagulation: clinical and laboratory aspects // Am. J. Hematol. — 1998; 59 (1): 65-73. https://doi.org/10.1002/(sici)1096-8652(199809)59:1<65::aid-ajh13>3.0.co;2-0.
[8] Levi M., de Jonge E., van der Poll T. New treatment strategies for disseminated intravascular coagulation based on current understanding of the pathophysiology // Ann. Med. — 2004; 36 (1): 41 https://doi.org/10.1080/07853890310017251.
[9] Шабалина А. А., Костырева М. В., Танашян М. М. Укутанные тромбоциты - новые возможности лабораторной диагностики нарушений тромбообразования // Анналы клинической и экспериментальной неврологии. — 2015. — Т. 9, № 3. — С. 56–60. [Shabalina A. A., Kostyreva M. V., Tanashyan M. M. Wrapped platelets - new possibilities of laboratory diagnosis of thrombus formation disorders // Annals of Clinical and Experimental Neurology. - 2015. - V. 9, No. 3. - P. 56-60].
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[11] Дзяк Г. В. Фракционированные и нефракционированные гепарины в интенсивной терапии / Г. В. Дзяк, Е. Н. Клигуненко, В. И. Снисарь — М.: Медпресс-информ, 2005. [Dzyak G. V. Fractionated and unfractionated heparins in intensive care / G. V. Dzyak, E. N. Kligunenko, V. I. Snisar - M.: Medpress-inform, 2005].
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[13] Мамот А. П. Современные аспекты патогенеза, диагностики и терапии ДВС-синдрома / А. П. Мамот, А. Н. Мамаев // Клиническая онкогематология. Фундаментальные исследования и клиническая практика. — 2008. — Т. 1, № 1. — С. 63-71. P. [Mamot Modern aspects of the pathogenesis, diagnosis and therapy of disseminated intravascular coagulation / A. P. Mamot, A. N. Mamaev // Clinical hematology oncology. Basic research and clinical practice. - 2008. - V. 1, No. 1. - P. 63-71].
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    Sadriddinov Asomidin Faizovich, Sheraliev Kambarali Saidalievich. (2021). Morphological Bases of DIC Syndrome in the Liver with Biliary Obstruction. International Journal of Clinical and Experimental Medical Sciences, 7(5), 138-142. https://doi.org/10.11648/j.ijcems.20210705.12

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    Sadriddinov Asomidin Faizovich; Sheraliev Kambarali Saidalievich. Morphological Bases of DIC Syndrome in the Liver with Biliary Obstruction. Int. J. Clin. Exp. Med. Sci. 2021, 7(5), 138-142. doi: 10.11648/j.ijcems.20210705.12

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    AMA Style

    Sadriddinov Asomidin Faizovich, Sheraliev Kambarali Saidalievich. Morphological Bases of DIC Syndrome in the Liver with Biliary Obstruction. Int J Clin Exp Med Sci. 2021;7(5):138-142. doi: 10.11648/j.ijcems.20210705.12

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  • @article{10.11648/j.ijcems.20210705.12,
      author = {Sadriddinov Asomidin Faizovich and Sheraliev Kambarali Saidalievich},
      title = {Morphological Bases of DIC Syndrome in the Liver with Biliary Obstruction},
      journal = {International Journal of Clinical and Experimental Medical Sciences},
      volume = {7},
      number = {5},
      pages = {138-142},
      doi = {10.11648/j.ijcems.20210705.12},
      url = {https://doi.org/10.11648/j.ijcems.20210705.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20210705.12},
      abstract = {Background: The development of disseminated intravascular coagulation syndrome (DIC), with liver pathologies, is usually considered a terminal condition caused by a violation of the blood coagulation system. A number of blood coagulation factors are synthesized by the liver, in this regard, the development of DIC syndrome in liver pathology is of particular importance. It is assumed that the DIC syndrome in liver pathology is caused by a violation of the coagulation properties of the blood. At the same time, local lesions of the hematocirculatory bed of the liver, as well as ultrastructural aspects of intravascular blood coagulation, remain unclear. Objective: To study the hematocirculatory bed of the liver and the features of the ultrastructure of platelet thrombi at 20-day experimental cholestasis in experimental white rats. Materials and methods: Experimental cholestasis was created in experimental rats (m=28) by ligation and transection of the common bile duct. The animals were sacrificed in compliance with ethical standards on days 10 and 20 of cholestasis. The liver tissue was examined by histological, corrosive, and electron microscopic methods. Results: Studies have shown that the development of DIC occurs with 20-day cholestasis, when biliary cirrhosis is formed in the liver. Some disorders of hemocirculation are observed at 10 days of cholestasis, in the form of erythrocyte sludge in the vessels of the liver. A pronounced disseminated intravascular coagulation syndrome manifests itself at 20 days of cholestasis. Disturbance of circulation is expressed in the interlobular branches of the portal system. Formed thrombi consist mainly of platelets with a minor admixture of erythrocytes and leukocytes. Ultrastructurally, a thrombus appears to be aggregated platelets, the structure of which is without significant changes. The elements of the hyalomer and granulomere are well detected in them. Most contain dense granules, some have undergone degranulation. A distinctive feature of a thrombus is the absence of fibrin filaments in the thrombus. Conclusion: Long-term experimental cholestasis, in some cases, is accompanied by a violation of the anticoagulant properties of the blood and contributes to the development of DIC. The morphological manifestation of which are platelet thrombi that arise in the interlobular veins. The ultrastructural features of these thrombi indicate an increase in the aggregation capacity of platelets, which, in combination with impaired hemostasis, probably contributes to the development of hemorrhage in liver pathology.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Morphological Bases of DIC Syndrome in the Liver with Biliary Obstruction
    AU  - Sadriddinov Asomidin Faizovich
    AU  - Sheraliev Kambarali Saidalievich
    Y1  - 2021/10/12
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijcems.20210705.12
    DO  - 10.11648/j.ijcems.20210705.12
    T2  - International Journal of Clinical and Experimental Medical Sciences
    JF  - International Journal of Clinical and Experimental Medical Sciences
    JO  - International Journal of Clinical and Experimental Medical Sciences
    SP  - 138
    EP  - 142
    PB  - Science Publishing Group
    SN  - 2469-8032
    UR  - https://doi.org/10.11648/j.ijcems.20210705.12
    AB  - Background: The development of disseminated intravascular coagulation syndrome (DIC), with liver pathologies, is usually considered a terminal condition caused by a violation of the blood coagulation system. A number of blood coagulation factors are synthesized by the liver, in this regard, the development of DIC syndrome in liver pathology is of particular importance. It is assumed that the DIC syndrome in liver pathology is caused by a violation of the coagulation properties of the blood. At the same time, local lesions of the hematocirculatory bed of the liver, as well as ultrastructural aspects of intravascular blood coagulation, remain unclear. Objective: To study the hematocirculatory bed of the liver and the features of the ultrastructure of platelet thrombi at 20-day experimental cholestasis in experimental white rats. Materials and methods: Experimental cholestasis was created in experimental rats (m=28) by ligation and transection of the common bile duct. The animals were sacrificed in compliance with ethical standards on days 10 and 20 of cholestasis. The liver tissue was examined by histological, corrosive, and electron microscopic methods. Results: Studies have shown that the development of DIC occurs with 20-day cholestasis, when biliary cirrhosis is formed in the liver. Some disorders of hemocirculation are observed at 10 days of cholestasis, in the form of erythrocyte sludge in the vessels of the liver. A pronounced disseminated intravascular coagulation syndrome manifests itself at 20 days of cholestasis. Disturbance of circulation is expressed in the interlobular branches of the portal system. Formed thrombi consist mainly of platelets with a minor admixture of erythrocytes and leukocytes. Ultrastructurally, a thrombus appears to be aggregated platelets, the structure of which is without significant changes. The elements of the hyalomer and granulomere are well detected in them. Most contain dense granules, some have undergone degranulation. A distinctive feature of a thrombus is the absence of fibrin filaments in the thrombus. Conclusion: Long-term experimental cholestasis, in some cases, is accompanied by a violation of the anticoagulant properties of the blood and contributes to the development of DIC. The morphological manifestation of which are platelet thrombi that arise in the interlobular veins. The ultrastructural features of these thrombi indicate an increase in the aggregation capacity of platelets, which, in combination with impaired hemostasis, probably contributes to the development of hemorrhage in liver pathology.
    VL  - 7
    IS  - 5
    ER  - 

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Author Information
  • Department of Histology and Pathological Physiology, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan

  • Department of Anatomy and Pathological Anatomy, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan

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