Disseminated intravascular coagulation, hemolytic anemia, and acute renal failure associated with extensive multiple myomectomy.
Disseminated intravascular coagulation (DIC) and acute renal failure are uncommon complications of multiple myomectomy. We report a case of DIC, microangiopathic hemolytic anemia, myoglobinemia, and acute renal failure following the removal of 52 uterine fibroids. We postulate that extensive myometrial dissection and the administration of hetastarch favored the development of DIC and microangiopathic hemolytic anemia. Acute renal failure ensued, necessitating hemodialysis. Proposed mechanisms and recommendations for future prevention are discussed.
Sacks
P C
PC
Division of Reproductive Endocrinology and Infertility, Georgetown University School of Medicine, Washington, DC.
Hoyne
P M
PM
D058186:Acute Kidney Injury / Q000209:etiology*; D000743:Anemia, Hemolytic / Q000209:etiology*; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000601:surgery; D011183:Postoperative Complications; D014594:Uterine Neoplasms / Q000601:surgery*