POSTOPERATIVE ABNORMAL PROTHROMBINEMIA IN PATIENTS WITH CEFOPERAZONE - REPORT OF 2 CASES

Two cases of postoperative abnormal prothrombinemia presumably caused by the administration of cefoperazone are herein described. One patien t, who had bile duct cancer with obstructive jaundice, underwent resec tion of the extrahepatic bile duct with hepaticojejunostomy (Rouxen-Y anastomosis) and partial resection of the liver following percutaneous transhepatic cholangial drainage. He developed abnormal prothrombinem ia and bleeding 10 days after surgery, The other patient, who had unde rgone a total gastrectomy 17 gears earlier, suffered from pulmonary tu berculosis. She was initiated anti-tuberculous regimen and simultaneou sly was worked-up for her severe anemia, and was found to have ascendi ng colon cancer, She underwent a right hemicolectomy, cholecystectomy, and repair of ventral incisional hernia, and subsequently developed a bnormal prothrombinemia and bleeding 12 days after surgery. Both patie nts received a chemical bowel preparation prior to surgery. Prothrombi n time was normal preoperatively in both patients, Both patients were treated with fresh frozen plasma and intravenous menatatrenon, which i mproved the clotting disorder within 24h. Antibiotics containing the n -methylthio-tetrazol side chain should thus be used with particular pr udence in patients with abnormal prothrombinemia and a tendency to dev elop bleeding disorders.