DIC occurs with activation of both the coagulation and fibrinolytic system resulting in thrombosis and hemorrhage. This may occur secondary to trauma, placental abruptio, sepsis, ARDS, and a variety of other disorders. While the hemorrhage is obvious, thrombosis of small and medium vessels accounts for the majority of morbidity and mortality. Treatment consists of treating the inciting disease process, but some cases require anticoagulation to prevent further thrombosis. Liver failure results in bleeding due to deficiencies of coagulation factors and disruption of platelet function.
Treatment consists of blood product replacement.
Preoperative screening for bleeding disorders remains a very controversial subject. Most bleeding disorders are obvious and are diagnosed prior to surgery. A small number of cases of mild Hemophilia or Von Willebrand's Disease may be uncovered at the time of surgery. Several studies have looked at the effectiveness of preoperative screening for adenotonsillectomy. Bolger et al found six coagulation disorders in 52 patients undergoing preoperative screening for adenotonsillectomy.