Abstract
An 82-year-old man was admitted to our hospital because of melena, whose grandchildren had been diagnosed as having von Willebrand disease. Colonoscopy revealed a type 2 tumor in the sigmoid colon. He was operated on with the diagnosis of sigmoid colon cancer that was well differentiated adenocarcinoma histopathologically. Preoperative blood examination revealed a low level of ristocetin cofactor activity of von Willebrand factor, and we diagnosed him as having von Willebrand disease (Type 2). We thus administered blood clotting factor VIII/von Willebrand factor concentrate for 5 days just before and after the operation, and successfully maintained the ristocetin cofactor activity of von Willebrand factor at above 80%. Postoperative course was uneventful.
Because von Willebrand disease causes dysfunction of platelet and destabilization of blood clotting factor VIII, von Willebrand factor should be administered in the perioperative period for the management of hemostasis.
