title: An uncommon cause of postoperative bleeding.
abstract: The postoperative phase can be associated with an increased risk of thrombosis and abnormal bleeding. We report the case of a patient admitted to our intensive care unit for postoperative monitoring who developed two episodes of hemorrhagic shock. A thromboelastogram performed with heparinase I digestion demonstrated the action of endogenous heparin-like substances whose presence was subsequently confirmed at the histological examination of the tumor. Heparinase-modified thromboelastography has proven to be an effective and rapid point-of-care coagulation test and in our case allowed early detection of circulating heparinoids.
authors.affiliation: Department of Anesthesia and Intensive Care, Cattinara University Hospital, Trieste, Italy. berlot@inwind.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Berlot
authors.forename: Fabiana
authors.initials: F
authors.lastname: Tartamella
authors.forename: Rossana
authors.initials: R
authors.lastname: Bussani
authors.forename: Michele C
authors.initials: MC
authors.lastname: Vassallo
authors.forename: Sabina
authors.initials: S
authors.lastname: Gerebizza
mesh_terms: D000368:Aged; D002291:Carcinoma, Papillary / Q000473:pathology / Q000601:surgery*; D019763:Heparin Lyase / Q000378:metabolism*; D006496:Heparinoids / Q000032:analysis / Q000097:blood*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D019106:Postoperative Hemorrhage / Q000209:etiology*; D013916:Thrombelastography / Q000379:methods*
chemical_list: D006496:Heparinoids; D019763:Heparin Lyase