Disseminated intravascular coagulation during total hip replacement

Disseminated intravascular coagulation (DIC) is an extremely serious hemorrhagic disorder and one that is potentially lethal. DIC is more frequently observed as a complication of obstetric pathologies, diffused neoplasms, bacterial sepsis, blood transfusions, traumas and adipose embolias. The literature reports very few cases occurring after total hip replacement, two of which the cause of death. In all of the cases described one or boh prosthetic components are cemented. The authors report a case observed after total hip replacement in a patient submitted one year previously to contralateral hip replacement. Severe hypotension, bradychardia and profuse bleeding of the wound and from the drainages one hour after suturing constituted the initial symptom. Recognition of the clinical findings, after exclusion of a iatrogenic lesion, and subsequent treatment in intensive therapy allowed us to save the patient. The syndrome must be suspected and immediately diagnosed when profuse bleeding that cannot be related to vascular lesion is observed immediately postsurgery after cemented or hybrid hip replacement. Confirmation through hematological tests and timely treatment in a specialized center are indispensable requirements to save the life of the patient.