• Katsuhiro Togami, Yuya Nagai, Hiroshi Arima, Sonoko Shimoji, Takahiro Kimura, Daichi Inoue, Minako Mori, Haruyuki Fujita, Sumie Tabata, Masayuki Kurata, Soshi Yanagida, Akiko Matsushita, Kenichi Nagai, Shuichiroh Kaji, and Takayuki Takahashi.
• Department of Hematology, Kobe City Medical Center, General Hospital.
• Rinsho Ketsueki. 2009 Dec 1;50(12):1700-5.

AbstractWe report here two patients with chronic disseminated intravascular coagulation (chronic DIC) secondary to aortic aneurysm, who were successfully treated with continuous subcutaneous infusion of heparin. The patients were 69- and 89-year-old males, who were admitted to our hospital because of thrombocytopenia and marked bleeding tendency. The underlying conditions were aortic dissection and aortic aneurysm, respectively. Coagulation test demonstrated that these patients had DIC, and a diagnosis of chronic DIC secondary to aortic aneurysm was made. Anti-coagulation treatment with oral camostat mesylate and daily subcutaneous infusion of heparin calcium was started. However, the treatment was insufficient to control chronic DIC, and these patients developed recurrent severe subcutaneous hemorrhages. Therefore, we attempted continuous subcutaneous infusion of heparin using a mobile infusion pump. This delivery of heparin markedly improved the coagulopathy, and the hemorrhagic episode disappeared with good compliance in the use of infusion equipment in these patients. Continuous subcutaneous infusion of heparin using a mobile infusion pump is effective and useful for long term treatment of chronic DIC by the outpatient department.

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