Case reports
Postoperative internal iliac artery embolisation as salvage therapy for bleeding in an HIV-positive patient with giant cell tumour of bone
Abstract
Giant cell tumour of bone (GCTB) is a highly vascular tumour, sporadically complicated by massive bleeding during surgery. We report a rare case of GCTB in an HIV-positive patient who suffered massive blood loss intra- and postoperatively. The patient was a 46-year-old HIV-positive female with symptoms and signs of a pelvic mass, and ultrasound evidence of an ovarian mass. Surgery was performed, and a highly vascular retroperitoneal mass originating from her sacrum was identified. Massive blood loss occurred, which required aggressive resuscitation and transfusion of blood products. Damage control surgery was performed, and bleeding was ultimately only controlled postoperatively using bilateral internal iliac artery radiological embolisation. The patient suffered acute kidney injury, which was multifactorial in aetiology, which recovered within 6 days. She was discharged from ICU in a stable condition 7 days postoperatively.
Authors' affiliations
Théa van den Heever, Department of Critical Care, Faculty of Health Sciences, University of the Free State, Bloemfontein
Claire L Barrett, Division of Clinical Haematology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein
Michael J Webb, Division of Clinical Haematology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein
Maryke G L Spruyt, Department of Critical Care, Faculty of Health Sciences, University of the Free State, Bloemfontein
Vernon J Louw, Division of Clinical Haematology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein
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Date published: 2015-09-18
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