Disseminated intravascular coagulation in a stage IV colon cancer patient: Report of a case and review of the literature

Approximately 20% of patients with colorectal carcinoma are iniatally seen with stage IV of the disease. Here, we report a 45-year old female patient with synchronous sigmoid colon cancer and multiple liver metastases. She underwent a palliative anterior resection and hepatic arterial infusion pump implantation. Left lower leg swelling developed four days after the operation and then shortness of breath was noted. Emergency lower extremity duplex ultrasound study proved the presence of left deep venous thrombosis. Chest helical computed tomography showed bilateral pulmonary arterial thromboembolism. Laboratory tests revealed a rapid decline in platelet counts and fibrinogen level, and the presence of fibrin-degradation products in plasma. Under the impression of disseminated intravascular coagulation, systemic heparinization with low-molecular-weight herapin was employed. Clinically speaking, the patient improved gradually with rise of platelet counts to the normal range several days later.