Work

Beyond the Bruise: Unmasking Disseminated Intravascular Coagulation in Alcohol-Related Presentations

Year: 2025

Type: article

Abstract: Disseminated intravascular coagulation (DIC) is a rare but life-threatening complication encountered in the emergency department (ED). It results from widespread activation of coagulation pathways, leading to simultaneous thrombosis and consumption of clotting factors, often culminating in severe bleeding and multi-organ failure. We report the case of a 39-year-old female with alcohol-related cirrhosis and autoimmune hepatitis who presented to the ED with a minor head injury and active bleeding from a groin ulcer. Her initial evaluation was confounded by alcohol intoxication and suspicion of domestic violence due to multiple bruises. Only after a delayed laboratory assessment was a diagnosis of DIC confirmed in the context of decompensated chronic liver disease with hepatic encephalopathy. She was treated with blood products and discharged with follow-up in the hepatology department. This case illustrates the diagnostic challenges of distinguishing trauma-related bruising from systemic coagulopathy in alcohol-related presentations. It emphasizes the importance of maintaining a high index of suspicion for DIC in cirrhotic patients, the role of the International Society on Thrombosis and Haemostasis DIC score, and the risks of diagnostic overshadowing in the ED. Early recognition and multidisciplinary intervention can significantly improve patient outcomes.

Source: Cureus

DOI: 10.7759/cureus.93352

Authors: Sri Amarnath Mathiyalagan, Aemon Fatima, Syeda Safa Sadiya, Lunik Sarder

Institutions: National Health Service, Barking, Havering And Redbridge University Hospitals NHS Trust

Language: English

Topic: Liver Disease and Transplantation

Subfield: Hepatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4414570469