Hemangioma-thrombocytopenia syndrome; a disseminated intravascular coagulopathy.

A patient who had multiple hemangiomas and for whom results of coagulation studies were consistent with 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.