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Disseminated intravascular coagulation during total hip replacement.
F A Zappoli1, L Brizio, C Alfonso
1Divisione di Ortopedia e Traumatologia, Policlinico S. Orsola-Malpighi, Bologna.
La Chirurgia Degli Organi Di Movimento
|January 2, 2003
Summary
Disseminated intravascular coagulation (DIC) is a rare but lethal complication following total hip replacement. Early recognition and intensive treatment are crucial for patient survival.
Area of Science:
- Orthopedic Surgery
- Hematology
Background:
- Disseminated intravascular coagulation (DIC) is a severe hemorrhagic disorder with high mortality.
- DIC is a known complication of various conditions, including sepsis, trauma, and obstetric pathologies.
- Cases of DIC following total hip replacement are rare, with some reported fatalities.
Observation:
- A patient developed severe hypotension, bradycardia, and profuse bleeding post-cemented total hip replacement.
- The patient had undergone contralateral hip replacement one year prior.
- Initial symptoms appeared one hour after suturing, with bleeding from the wound and drainages.
Findings:
- Clinical recognition of DIC, after excluding iatrogenic causes, is key.
- Prompt diagnosis and intensive care management were critical in saving the patient.
- Hematological tests are essential for confirming the diagnosis of DIC.
Implications:
- DIC should be suspected in cases of unexplained profuse bleeding after cemented or hybrid hip replacement.
- Timely diagnosis and treatment in a specialized center are vital for improving patient outcomes.
- This case highlights the importance of vigilance for DIC in orthopedic surgery patients.