A patient who had multiple hemangiomas and for whom results of coagulation studies were consistent with the hemangioma-thrombocytopenia (Kasabach-Merritt) syndrome and a microangiopathic hemolytic process was asymptomatic prior to surgical removal of a lipoma. Postoperatively, she developed bleeding secondary to a disseminated intravascular coagulopathy. Her bleeding was controlled by anticoagulation therapy. A review of the literature provides evidence suggesting that the hemangioma-thrombocytopenia syndrome is due to a disseminated intravascular coagulopathy initiated within the hemangioma. Surgical trauma may precipitate exacerbations of the coagulopathy in these patients and all unnecessary surgical procedures should be avoided.
Lang PG, Dubin HV. Hemangioma-Thrombocytopenia SyndromeA Disseminated Intravascular Coagulopathy. Arch Dermatol. 1975;111(1):105-107. doi:10.1001/archderm.1975.01630130107016