Abstract
We report a patient with advanced gastric carcinoma associated with congenital factor χ deficiency, who underwent radical surgery with administration of Coagulation Factor Complex. A 71-year-old man, who had received a previous nasal operation during which massive bleeding was encountered, was referred to our hospital for closer examination of his bleeding tendency. The closer examination revealed a decreased level of factor χ (45%), which lead to a diagnosis of congenital factor χ deficiency. As the patient presented with epigastralgia, he received gastric fiberscopy, which detected a Type 2 gastric carcinoma of 6 cm in maximum diameter in the antrum. In order to determine an adequate dose of the combined Coagulation Factor Complex (PPSB-HT) for perioperative administration, we monitored the serum level of factor χ after injection of the coagulant. The operation was carried out with administration of PPSB-HT, performing total gastrectomy with combined resection of the spleen and the transverse colon, and D4 lymphadenectomy. During and after the operation, no abnormal hemorrhage was observed. Our experience may encourage radical resection of advanced malignancy in the GI tract despite association with coagulant factor deficiency as long as Coagulation Factor Complex is available and intensive hemostasis is performed.
