Thrombocytopenia following peritonitis in surgical patients. A prospective study.

TitleThrombocytopenia following peritonitis in surgical patients. A prospective study.
Publication TypeJournal Article
Year of Publication1986
AuthorsIberti TJ, Rand JH, Benjamin E, Gentili DR, Gabrielson GV, Berger SR, Aufses AH
JournalAnn Surg
Date Published1986 Oct
KeywordsDisseminated Intravascular Coagulation, Fibrinogen, Humans, Laparoscopy, Peritonitis, Platelet Count, Postoperative Complications, Prospective Studies, Thrombocytopenia

Thrombocytopenia is commonly found in patients with serious infection. To investigate this phenomenon, 14 consecutive patients (68 +/- 10 years) who underwent laparotomy for bowel perforation and culture-proven peritonitis were prospectively studied. Ten noninfected laparotomy patients served as a control group. None of the 10 control patients developed thrombocytopenia. Of the infected group, 12 of 14 patients (85%) developed thrombocytopenia (less than 100,000/mm3). One patient (9%) developed disseminated intravascular coagulation (DIC). Of the remaining 11 patients with thrombocytopenia, platelet counts fell from preoperative level of 350,000 +/- 166,000 to 54,000 +/- 30,000 (p less than 0.001) and reached this nadir 4.3 +/- 2 days after surgery. There was no statistically significant difference in prothrombin time, partial thromboplastin time, or fibrinogen levels before versus after operation in this group. Bleeding times in seven patients were 5.5 +/- 2 minutes, and bone marrow examination in five patients with platelet counts of less than 50,000/mm3 revealed normal or increased megakaryocytes. No patient in this group bled, had medications held, or received platelet transfusions. Platelet counts increased greater than 100,000/mm3 at a mean of 8.9 +/- 4.1 days after operation. It is concluded that thrombocytopenia is common following surgery for intra-abdominal infection, is not usually associated with DIC, clinical bleeding, or coagulation abnormalities, does not commonly result from bone marrow suppression, and is transient and does not require routine platelet transfusions.

Alternate JournalAnn Surg
PubMed ID2945517
PubMed Central IDPMC1251294
Related Faculty: 
Jacob H. Rand, M.D.

Pathology & Laboratory Medicine 1300 York Avenue New York, NY 10065 Phone: (212) 746-6464
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