[abstract] AN AUTOPSY CASE OF ACUTE DECOMPRESSION SICKNESS - ROLE OF INCREASED COAGULABILITY IN DECOMPRESSION SICKNESS OF PATHOLOGICAL BASES.

Abstract

Decompression sickness is still popular among occupational diseases in Japan. We have previously suggested a definite importance of increased coagulability on the pathogenesis in decompression sickness. This report presents autopsy findings of a 28 year-old male case of acute decompression sickness and further pathophysiological evidences. In the autopsy case, the spinal cord showed early stage of edematous necrosis accompanied by extensive intravascular coagulation with bubble and fat embolism in the epidural venous plexus. Platelet aggregation and thrombus formation around bubbles were also found in the bone marrow tissue of femur in which extensive necrotic processes developed. The lungs revealed severe congestion, edema and intraalveolar hemorrhage in association with extensive fat embolism. Similar lesions were reproduced in the experimental rabbits. Application of FITC-conjugated anti-rabbit-fibrinogen sheep-IgG documented accumulation of fibrinogen in the vessels of the lung and the bone marrow tissue of femur. Therefore it might be reasonable to consider that the circulatory disturbance due to increased coagulability plays an important role on the pathogenesis of decompression sickness.