Abstract |
Systematic complementary testing for asymptomatic patients before surgery yields an unexpectedly high percentage of anomalous results. Such results rarely affect perioperative management of the patient but may lead to unnecessary delays, which are potentially of great importance in emergency surgery. A 55-year-old woman with a clinical diagnosis of acute appendicitis was seen to have a prolonged activated partial thromboplastin time (APTT) of 1.94 before surgery. The patient's history did not suggest a coagulation disorder was likely, and when mixing normal and problem plasma failed to correct the APTT, we suspected an unspecified circulating anticoagulant was present. Surgery was delayed no further and no measures were taken. No excessive bleeding occurred during surgery or postoperative recovery. The main possible diagnoses for a women with unforeseen prolonged APTT are the presence of an unspecified circulating anticoagulant, factor XI or factor XII deficiency, or factor VIII deficiency associated with von Willebrand disease. Focusing on detecting a coagulation disorder while taking a patient's history and performing a simple laboratory test (mixing normal and problem plasma) can be useful for orienting management in emergency surgery.
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Authors | J Barrio, V Peris, I Asensio, I Molina, F López, V García |
Journal | Revista espanola de anestesiologia y reanimacion
(Rev Esp Anestesiol Reanim)
Vol. 49
Issue 8
Pg. 424-7
(Oct 2002)
ISSN: 0034-9356 [Print] Spain |
Vernacular Title | Tiempo de tromboplastina parcial activado prolongado no sospechado en cirugía de urgencia. Orientación diagnóstica y terapéutica. |
PMID | 12455323
(Publication Type: Case Reports, English Abstract, Journal Article)
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Topics |
- Blood Coagulation Disorders
(blood, diagnosis, therapy)
- Emergencies
- Female
- Humans
- Middle Aged
- Partial Thromboplastin Time
- Preoperative Care
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