PERSISTENT HEMORRHAGE FOLLOWING DENTAL EXTRACTIONS IN PATIENTS WITH LIVER-DISEASE - 2 CAUTIONARY TALES

Two cases are reported in which patients known to suffer from chronic liver disorders underwent local anaesthetic dental extractions. In bot h cases the procedure was followed by severe, intractable post-operati ve haemorrhage, resistant to local haemostatic measures and requiring hospital admission for intravenous fluid replacement and administratio n of clotting factors. The importance of not only eliciting details up on that information is emphasised and a recommendation is made that pa tients with active liver disorders, such as cirrhosis, who require ora l surgery procedures should be managed in hospital departments, where access to haematological assessment and appropriate surgical and medic al care is readily available. Close liaison with liver physicians and haematologists is recommended.