Disseminated intravascular coagulation (DIC)

Meet the patient

A 60-year-old man with perforated diverticulitis reaches the unit in septic shock — purpura across his shins, blood oozing from cannula sites, a platelet count that has fallen from 288 to 42 overnight, fibrinogen 0.9 g/L and a D-dimer far above the upper normal limit. He is bleeding from puncture sites while his kidneys fail — the two faces of DIC at once.^[1]

The two questions that decide his next hour: what is the underlying condition? (treating it is the cornerstone) and is this thrombotic or haemorrhagic DIC? (it decides between heparin and products).^[3][1]

References21ShowHide

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