TY - JOUR A2 - Georgiadou, P. A2 - Masotti, L. AU - Hoshina, Katsuyuki AU - Kaneko, Makoto AU - Hosaka, Akihiro AU - Okamoto, Hiroyuki AU - Shigematsu, Kunihiro AU - Miyata, Tetsuro PY - 2012 DA - 2012/08/09 TI - Lessons Learned from a Case of Abdominal Aortic Aneurysm Accompanied by Unstable Coagulopathy SP - 265860 VL - 2012 AB - Preoperative examination for abdominal aortic aneurysms (AAAs) occasionally reveals an abnormal decrease in coagulation factors and thrombocytopenia, fulfilling the criteria for disseminated intravascular coagulation (DIC). Treatment of the underlying disorder is indispensable for alleviating DIC. We report an uncommon case of a patient with AAA and DIC who showed prolonged thrombocytopenia despite successful treatment of AAA and temporary recovery of coagulation factors. A 70-year-old man presented with AAA and shaggy aorta accompanied by DIC and underwent aneurysmectomy. Combined preoperative use of nafamostat mesilate and recombinant human soluble thrombomodulin was effective in controlling DIC. Although recovery of coagulation factors was observed after surgery, the thrombocytopenia continued throughout the postoperative course and was refractory to platelet transfusion. Because HPA antibody and PA-IgG were present, a trial administration of γ-globulin was performed; this resulted in rapid improvement of thrombocytopenia. Although DIC recurred again 2 weeks thereafter, coagulation factors subsequently recovered without any medication. SN - 2090-6986 UR - https://doi.org/10.1155/2012/265860 DO - 10.1155/2012/265860 JF - Case Reports in Vascular Medicine PB - Hindawi Publishing Corporation KW - ER -