Management of disseminated bleeding in a patient with multiple malignomas using rotation thromboleastometry

[english] We report on a case of Klippel-Trenaunay syndrome with a histologically diagnosed dedifferentiated angiosarcoma. During operative tumor debulking, a disseminated bleeding developed which required a massive transfusion of red blood cell concentrates and therapeutic plasma. While plasmatic c...

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Veröffentlicht in:GMS. German plastic, reconstructive and aesthetic surgery, burn and hand surgery reconstructive and aesthetic surgery, burn and hand surgery, 2014-04, Vol.4, p.Doc05
Hauptverfasser: Kolbenschlag, Jonas, Wittenberg, Gerhard, Lehnhardt, Marcus, Goertz, Ole
Format: Artikel
Sprache:ger
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Zusammenfassung:[english] We report on a case of Klippel-Trenaunay syndrome with a histologically diagnosed dedifferentiated angiosarcoma. During operative tumor debulking, a disseminated bleeding developed which required a massive transfusion of red blood cell concentrates and therapeutic plasma. While plasmatic coagulation was within normal range, thromboelastometry showed a distinct hyperfibrinolysis. The bleeding was controlled by prolonged cauterisation and the substitution of tranexam acid as well as fresh frozen plasma. As a result of this treatment, hyperfibrinolysis showed complete restitution within a few hours. Histologically, a malignant peripheral nerve sheat tumor, a dedifferentiated angiosarcoma, a spindle cell sarcoma and an osteosarcoma were diagnosed within the tissue samples.
ISSN:2193-7052
2193-7052
DOI:10.3205/gpras000024