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Updated: Jun 4, 2026
05:59
Murine Model of Metastatic Liver Tumors in the Setting of Ischemia Reperfusion Injury
Published on: August 30, 2019
An uncommon cause of postoperative bleeding
Giorgio Berlot1, Fabiana Tartamella, Rossana Bussani
1Department of Anesthesia and Intensive Care, Cattinara University Hospital, Trieste, Italy. berlot@inwind.it
Summary
Postoperative patients may experience bleeding or clotting. This case highlights how heparinase-modified thromboelastography rapidly detected endogenous heparinoids causing hemorrhagic shock, aiding early diagnosis.
Area of Science:
- Anesthesiology
- Hematology
- Oncology
Background:
- Postoperative complications include thrombosis and abnormal bleeding.
- Intensive care unit (ICU) monitoring is crucial for high-risk patients.
- Hemorrhagic shock is a life-threatening condition requiring prompt management.
Observation:
- A patient in the ICU for postoperative monitoring experienced two episodes of hemorrhagic shock.
- Initial assessments suggested a coagulopathy.
- The patient had a tumor, which was later examined histologically.
Findings:
- Thromboelastography with heparinase I digestion revealed endogenous heparin-like substances.
- Histological examination confirmed the presence of these heparinoids in the tumor.
- Heparinase-modified thromboelastography proved effective for early detection.
Implications:
- Heparinase-modified thromboelastography is a valuable point-of-care test for diagnosing heparinoid-induced coagulopathies.
- Early detection of circulating heparinoids can guide treatment and improve patient outcomes.
- This case underscores the importance of advanced coagulation monitoring in complex postoperative patients.
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