Re: Alcoholic with DUB

From: ainsron@msn.com
Sat Jun 24 11:24:56 2000


>Portal hypertension causes varices in the veins that lead to the
>porta hepatis - were there any varices in the vagina?? I think not.

Your correct, I didn't see any vaginal varices

>Hypersplenism?? What is the connection??

>From what I've read recently, hypersplenism is the most likely cause. It
causes this exact type of picture, thrombocytopenia with neutropenia. If alcoholic liver disease was specifically causing this bleeding problem, I would have expected a disturbance in PT, PTT and INR, which were completely normal.

>Von Willebrand's?? Sparrows are more common than canaries.

Von Willebrand's results in a bleeding time prolongation is prolonged but its always been measurable in other patients I've taken care of. In this patient it over 30 minutes. Also because of low factor VIII, there should be an elevated PT/INR, this patient's were normal.

--
Ronald E. Ainsworth, MD




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