Accidental Haemorrhage

Abstract

Summary (1) Even if it be accepted that thrombokinase liberation follows accidental haemorrhage, it should not be assumed that visceral fibrin thrombi which are known to occur in the tissues of accidental haemorrhage are due to the hypercoagulability of the blood which follows thrombokinase liberation. There are many causes of thrombosis and, as far as the kidney is concerned, the thrombi are due to vasospasm in the cortical arteries and arterioles. (2) Fibrin thrombi can occur in the pulmonary vessels in cases of accidental haemorrhage, but only careful comparative studies of the time of onset of incoagulability of the blood and the time of formation of the thrombus can determine the exact relationship. (3) The fibrinogenopenia which occurs in cases of accidental haemorrhage is often ascribed to an earlier stage of extensive intravascular thrombosis—this is the disseminate fibrin thrombi theory. The evidence in support of this hypothesis is not convincing.