Case Report: Disseminated Intravascular Coagulation (DIVC) Secondary to Surgical Management of Gastric Adenocarcinoma

Gastric adenocarcinoma is a cancer which emerges from the gastric tissue. More than 90% of gastric cancers are adenocarcinomas. Disseminated intravascular coagulation (DIVC) is characterized by a widespread activation of coagulation, resulting in increased intravascular formation of fibrin and thrombotic occlusion of small and mid-size vessels. A 47 years old Malay man, diagnosed with gastric adenocarcinoma stage III was admitted to the surgical ward for preparation of curative total gastrectomy operation. Intraoperative findings noted advanced gastric adenocarcinoma with distant metastasis. Patient underwent laporatomy, feeding jejunostomy and cholecystojejunostomy as palliative management. However, this condition was further complicated by acute disseminated intravascular coagulation (DIVC) which required the DIVC regimen of 4 units of fresh frozen plasma, 6 units cryoprecipitate and 2 units of platelet concentrate. Surgical resection is the only curative treatment for gastric cancer. Gastric cancer diagnosed at an advanced stage has poor prognosis, hence early diagnosis is crucial in influencing the outcome of surgical treatment. DIVC is known as secondary complication of an underlying disease among cancer patients, and precautions are imperative elements. Treatment of DIVC may include platelets, red blood cells, plasma cryoprecipitate transfusions, and antibiotics.