止血に難渋した慢性DIC患者における抜歯後出血の1例

• Published in: 日本口腔外科学会雑誌 Vol. 59; no. 10; pp. 653 - 657
• Main Authors: 寺本, 祐二, 西牧, 史洋, 鎌田, 孝広, 小池, 剛史, 篠原, 淳, 栗田, 浩
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.10.2013
• Subjects: 動脈瘤; 慢性播種性血管内凝固症候群; 抜歯後出血
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.59.653

Disseminated intravascular coagulopathy (DIC) is an acquired bleeding disorder characterized by an imbalance in the hemostatic process, resulting in extensive thrombosis and hemorrhagic complications. DIC exists in both acute and chronic forms. Chronic DIC (compensated DIC) may be associated with subclinical signs and symptoms, and the bleeding disorder may only be identified by laboratory findings. In this paper we report a case of refractory post-extraction hemorrhage compromised by chronic DIC. A 69-year-old man was referred to our hospital because of prolonged bleeding after tooth extraction. The patient had a medical history of large thoracic and abdominal aortic aneurysms. Clinical examination revealed continuous bleeding at the tooth extraction site. Other clinical signs of a hemorrhagic diathesis were not evident. The results of laboratory examinations suggested the possibility of chronic DIC. In this patient, oral bleeding was finally managed by continuous intravenous infusion of heparin. After that, the patient received careful medical and dental follow-up treatment in our hospital and had no further problems.