A Case of Gastric Cancer with Congenital Platelet Dysfunction and Hemophilia B

Abstract

We report a case of gastric cancer in a patient with congenital platelet dysfunction and hemophilia B who underwent laparoscopic distal gastrectomy. The patient was a 59-year-old man referred to our department after he was diagnosed as early cancer of lower gastric body. Preoperatively, activated partial thromboplastin time was slightly increased and so, the surgery was carried out under administration of fresh frozen plasma (FFP). Breeding not responding to FFP lasted even after the surgery, resulting in reoperative surgery. And a large amount of blood clot was found in the abdominal cavity. During the elimination of blood clot, a small pulsatile bleeding was disclosed in the site of gastrojejunostomy. Though bleeding at the site was easily stopped, but a hemorrhagic sign was observed in the tissue. The platelet aggregation ability and the activity of blood aggregation factor IX were lowered when compared with the respective preoperatively-evaluated levels. So, he received a combined administration of concentrated platelet and factor IX preparation. Thus, the tendency of bleeding disappeared after the reoperative surgery. Since he had neither underlying disease nor history of drug use leading to platelet dysfunction, he was diagnosed as congenital platelet dysfunction and hemophilia B.