Internal Medicine

P1: RLJ/OZN P2: KUF

0521779407-D-01 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:41

494 Disseminated Intravascular Coagulation Diverticulitis

follow-up

DIC

■Follow hematocrit and serial coagulation tests: PT, PTT, fibrinogen,

platelets.

■Support with blood products as necessary if patient is bleeding or it

is otherwise indicated (trauma/surgery)

TTP/HUS

■Follow hematocrit, platelet count, LDH, and creatinine levels.

■Transfuse with packed red blood cells as necessary.

complications and prognosis

DIC

■Complications in DIC are often related to the underlying illness.

■DIC with thrombosis can cause complications related to embolic

phenomena.

■Depending on the underlying cause, DIC can be mild and self-limited

(as in some infections) or severe and life-threatening (amniotic fluid

emboli which have a high mortality rate).

HUS in a Child with a History of a Diarrheal Illness

■Children with HUS due to verocytotoxin-producing E. coli or Shigella

generally recover spontaneously with supportive care and rarely

require plasmapheresis.

TTP/HUS

■With plasma exchange, 90% of patients with TTP respond to treat-

ment, 30% will subsequently relapse within weeks after this treat-

ment is stopped – plasma infusion may be of utility for these indi-

viduals.

■Renal failure or neurologic deficits may be long-lasting or perma-

nent.

Diverticulitis and Diverticular Disease.....................

JOHN P. CELLO, MD

history & physical

■Note proper nomenclature:

➣diverticulum (singular)