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Updated: Mar 27, 2026

Massive Pontine Hemorrhage by Dual Injection of Autologous Blood
Published on: May 29, 2021
Severe bleeding diathesis after dental extractions: a complex case of coagulation disturbances in a patient with
Fernanda de Paula Eduardo1, Leticia Mello Bezinelli1, Vitor Abreu de Goes1
1Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Abstract:
This case report describes a male patient diagnosed with multiple myeloma who experienced significant bleeding from both the maxillary and mandibular dental sockets following dental extraction, lasting several days. Laboratory tests revealed prolonged prothrombin time and thrombin time, accompanied by reduced factor VII levels. Initial management with intravenous vitamin K and fresh frozen plasma failed to achieve hemostasis. Despite the risk of thrombosis, low-dose tranexamic acid was initiated, resulting in effective hemorrhage control and improved healing of the alveolar sockets. This case illustrates the complex hemostatic imbalance between pro- and anticoagulant factors in a patient with multiple myeloma. It also underscores the diagnostic and therapeutic challenges associated with managing bleeding in patients with a high risk of thrombosis.
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