The role of prothrombin complex concentrate to control critical bleeding after splenectomy for blunt abdominal trauma; A case report

Abstract

Blunt abdominal trauma is an event that can cause massive internal bleeding and can be life-threatening. Splenectomy is often performed to treat organ injuries in patients with blunt abdominal trauma. However, splenectomy can cause hemostasis problems, which can cause more bleeding and risk complications such as Acute Kidney Injury (AKI). This case report aims to discuss the role of prothrombin complex concentrate (PCC) in treating bleeding and preventing AKI in blunt abdominal trauma patients after splenectomy at Fatmawati Hospital, Jakarta, Indonesia. A 15-year-old woman experienced blunt abdominal trauma due to a sports accident and sustained internal bleeding. After a thorough evaluation, she underwent an emergency splenectomy to stop the bleeding. However, patients developed hemostasis problem which made the control of postoperative bleeding difficult. To overcome this problem, patient was administered PCC intravenously, which resulted in significant improvement in controlling postoperative bleeding. The hematocrit level and red blood cell count steadily increased, indicating the effectiveness of PCC in improving the patient's hemostasis. PCC can play an important role in treating post-splenectomy bleeding in patients with blunt abdominal trauma. Apart from that, the use of PCC can also help prevent AKI, which is a serious and life-threatening complication. Further research and clinical trials are needed to confirm the benefits of using PCC in a broader patient population with similar conditions. Abbreviations: AKI- Acute Kidney Injury; PCC- Prothrombin Complex Concentrate Keywords: Acute Kidney Injury; Bleeding; Blunt Abdominal Trauma; Prothrombin Complex Concentrate; Splenectomy Citation: Laksana AP, Manggala SK, Irawany V. The role of prothrombin complex concentrate to control critical bleeding after splenectomy for blunt abdominal trauma; A case report. Anaesth. pain intensive care 2024;28(1):177−181; DOI: 10.35975/apic.v28i1.2289 Received: September 13, 2023; Reviewed: October 29, 2023; Accepted: December 19, 2023