Abstract
A 62-year-old woman presented with a chief complaint of bloody stool while being treated for hepatitis C at the Department of Internal Medicine at our hospital and sigmoid colon cancer was diagnosed after a detailed stool examination. The patient had a history of pulmonary infarction after delivery at the age of 31. Her blood test was positive for anticardiolipin-β2GP-I complex antibody, and antiphospholipid antibody syndrome was diagnosed in 2004. Therefore, anticoagulant therapy was started. She was treated with oral warfarin potassium after mitral valve replacement (prosthetic valve); however, this drug was discontinued and unfractionated heparin was started. The administration of unfractionated heparin was preoperatively discontinued, and resection of the sigmoid colon cancer was performed. Anticoagulant therapy was restarted immediately after the operation; however, postoperative bleeding from the resection site was observed, leading to hematoma formation in the abdominal cavity. In addition, there was bleeding from the anastomotic site during adjustment of the anticoagulant dose, for which blood transfusion was needed. Thereafter, the hematoma was suspected of being infected, and 63 days after the operation the hematoma was removed. The postoperative course was good without fatal thrombosis, and the patient was discharged from the hospital. Here, we report a case of antiphospholipid antibody syndrome with difficulty in perioperative anticoagulant therapy, with some bibliographic considerations.
