Open AccessUnbelievable but true: Partial thromboplastin time, kaolin 120 s and yet no surgical bleed!
Author(s) -
Shagun Bhatia Shah,
Vani Bhageria,
Binod Kumar Naithani,
Ajay Bhargava
Publication year - 2017
Publication title -
the indian anaesthetists' forum
Language(s) - English
Resource type - Journals
eISSN - 2589-7934
pISSN - 0973-0311
DOI - 10.4103/theiaforum.theiaforum_8_17
Subject(s) - bleed , medicine , partial thromboplastin time , lupus anticoagulant , breast cancer , deep vein , thrombosis , surgery , thromboplastin , coagulation , venous thrombosis , cancer
Partial thromboplastin time, kaolin (PTTK) is a global test sensitive to low levels of all the coagulation factors, except Factor VII and Factor XIII. Patients with extensive cancer have a propensity to develop a shortened PTTK. Our breast cancer patient had a prolonged PTTK result roughly 4 times the normal values. A detailed description of the preoperative workup including the special investigations is required to ascertain the cause of the prolongation and precautions taken, leading to successful breast cancer surgery and postoperative period in this patient follows. Allowing the surgeon to operate a patient with a PTTK >120 s and simultaneously at risk of thrombosis due to lupus anticoagulant is possible with a calculated risk and thorough preoperative evaluation. Prophylactic fresh frozen plasma and deep venous thrombosis prophylaxis have an important role