STUDIES ON A PROTEOLYTIC ENZYME IN HUMAN PLASMA. VII. A FATAL HEMORRHAGIC STATE ASSOCIATED WITH EXCESSIVE PLASMA PROTEOLYTIC ACTIVITY IN A PATIENT UNDERGOING SURGERY FOR CARCINOMA OF THE HEAD OF THE PANCREAS 1

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Abstract
A fatal hemorrhagic state was observed in a female patient undergoing surgery for carcinoma of the head of the pancreas. The patient''s blood was incoagulable despite the presence of appreciable amts. of fibrinogen. It was not possible to demonstrate the presence of a circulatory anticoagulant. There was slight hypoprothrombinemia insufficient to account for the blood''s failure to clot. Moreover the patient''s plasma corrected the clotting defect of hemophilic plasma. The patient''s plasma was found to possess extreme fibrinolytic and fibrinoginolytic activity. The patient''s blood apparently failed to clot because the fibrinogen it contained was probably destroyed before any detectable quantity of fibrin formed.