Hypofibrinogenemia Caused by Hemocoagulase After Colon Polyps Excision

Area of Science:

• Gastroenterology
• Hematology
• Pharmacology

Background:

• Patients with large colon polyps may experience late-onset bleeding due to larger surgical cutting surfaces.
• Hemostatic agents are sometimes used to mitigate this risk.
• Hemocoagulase is one such agent considered for preventing post-excision bleeding.

Observation:

• Seven patients receiving hemocoagulase post-colon polyp excision developed hypofibrinogenemia (low fibrinogen levels) 2-4 days after treatment initiation.
• Three of these patients also experienced lower-gastrointestinal bleeding.
• In contrast, 13 control patients not receiving hemocoagulase showed normal fibrinogen levels post-surgery.

Findings:

• Intravenous hemocoagulase administration, twice daily from postoperative day 1, was associated with a significant decrease in blood fibrinogen levels.
• Hypofibrinogenemia resolved after hemocoagulase withdrawal and fibrinogen infusion.
• The incidence of hypofibrinogenemia and associated bleeding was linked to hemocoagulase use.

Implications:

• Routine prophylactic use of Hemocoagulase For Injection following colon polyp excision is not advised.
• Clinicians should be aware of the potential risk of hemocoagulase-induced hypofibrinogenemia and lower-gastrointestinal bleeding.
• Alternative hemostatic strategies should be considered for patients undergoing colon polyp excision.