2020 Volume 53 Issue 7 Pages 598-604
A 35-year-old woman noticed abdominal pain during a course of transfusion-dependent severe aplastic anemia. She was given a diagnosis of abdominal wall abscess due to a penetrating anastomotic ulcer after colorectal cancer surgery. We evaluated the reactivity of platelet transfusions and the degree of bone marrow failure by G-CSF administration before surgery to prevent perioperative complications. The platelet count increased after the platelet transfusion, but the leukocyte count did not increase after the G-CSF administration. After transfusions of platelets and red blood cells, the anastomotic resection was performed by laparotomy. Although the wound infection and intraperitoneal infection at the abscess cavity were observed postoperatively, perioperative management including drainage, antibiotic treatment, and platelet and red blood cell transfusions was performed, and the patient was discharged 55 days after surgery. Optimal perioperative management of patients with severe aplastic anemia undergoing gastroenterological surgery has not been established. We consider that it is essential to evaluate the severity of bone marrow failure and transfusion responsiveness before surgery, and to be prepared according to the appropriate transfusion therapy.
