Kasabach-Merritt症候群により抜歯後出血を来した1例

抄録

Kasabach-Merritt syndrome is a coagulation disorder caused by hemangioma, usually resulting in chronic disseminated intravascular coagulation (DIC). We report a case of post-extraction hemorrhage with Kasabach-Merritt syndrome. A 54-year-old man was referred to our department because of persistent hemorrhage after extraction of the left lower first molar. Although we performed local hemostatic treatment, intermittent hemorrhage persisted. Blood examination revealed abnormal coagulation, and the patient had a medical history of giant hemangioma of the liver. We therefore suspected post-extraction hemorrhage caused by Kasabach-Merritt syndrome and consulted with a hematologist. The patient was given a diagnosis of Kasabach-Merritt syndrome and received camostat mesilate. We continued local hemostatic treatment, and hemostasis was successfully achieved. About 10% of patients with hemangioma of the liver have Kasabach-Merritt syndrome. In patients with hemangioma who have abnormal bleeding such as post-extraction hemorrhage, the possibility of chronic DIC should be included in the differential diagnosis.