Abstract
The hemorrhagic diathasis which accompanies obstructive jaundice has been a serious obstacle in the treatment of this condition. Petren 1 states that 2% of the cases of obstructive jaundice submitted to operation die of hemorrhage. In an analysis of the cases of obstructive jaundice in the New York Hospital over a period of 3 years, 50% of the operative deaths were due to hemorrhage. Walters 2 reported a similar experience.
Chemical analysis of the blood has failed to give any clue as to which patients would bleed following operation. Although the clotting time and bleeding time is increased in most instances there is no correlation between prolonged bleeding and clotting time and the hemorrhagic diathasis. Kirk and King, 3 Snell and Green, 4 Snell, Green and Rowntree, 5 Linton, 6 and Ravdin and Regal 7 concluded that the changes in the blood calcium are insufficient to explain the condition. Similarly, Moss, 8 Barke and Weir 9 found no significant variation in the fibrinogen. Doyen 10 states that the concentration of bile in the blood of subjects suffering from obstructive jaundice is insufficient to interfere with the clotting of blood. Bancroft 11 reported that the platelets of patients suffering from obstructive jaundice are normal in number and fragility. In an excellent review of the literature, Wangensteen 12 concludes that prediction of the hemorrhagic diathasis is not possible with the present methods.
It is significant that two basic factors concerned with the clotting of blood have never been investigated. It is the purpose of this investigation to examine the heparin and the lipid amino N in the blood of experimental animals suffering from obstructive jaundice.
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