Hemorrhage associated with dacryocystorhinostomy and the adjunctive use of desmopressin in selected patients.
Of 150 consecutive patients who underwent dacryocystorhinostomy, postoperative hemorrhage requiring treatment occurred in 2 patients, both of whom had endogenous platelet dysfunction without thrombocytopenia. The first patient had macroglobulinemia, and the second patient had congenital platelet hypofunction. Prophylactic 1-deamino-8-D-arginine vasopressin (desmopressin; DDAVP) was used successfully to decrease intraoperative bleeding in the second patient. Of the 15 patients with exogenous platelet dysfunction secondary to the use of aspirin or nonsteroidal anti-inflammatory agents within 1 week of operation, none had hemorrhaging. Dacryocystorhinostomy should be undertaken cautiously and with hematologic consultation in patients with blood dyscrasias.
Bartley
G B
GB
Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905.
Nichols
W L
WL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D001791:Blood Platelet Disorders / Q000150:complications; D003607:Dacryocystitis / Q000601:surgery; D003608:Dacryocystorhinostomy / Q000009:adverse effects*; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D004844:Epistaxis / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D009301:Nasolacrimal Duct / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology*; D008258:Waldenstrom Macroglobulinemia / Q000150:complications
D003894:Deamino Arginine Vasopressin