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MASSIVE POSTOPERATIVE HEMORRHAGE DUE TO UNRECOGNIZED THROMBOCYTOPENIA

CHARLES W. McLAUGHLIN, M.D.; JOHN D. COE, M.D.
AMA Arch Surg. 1954;69(3):378-384. doi:10.1001/archsurg.1954.01270030106009.
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THE CLINICAL significance of acute and chronic thrombocytopenic purpura has been well understood for many years. The simultaneous occurrence of such a condition during the immediate postoperative period presents additional problems which require prompt recognition and careful treatment. Our recent experience with seven such cases has focused our attention on this particular problem.

The function of the platelets in circulating blood was recognized and described by Bizzozero in 1882. He demonstrated their adhesive qualities, participation in thrombi, and the role in the coagulation of blood. The actual origin of these platelets has been the subject of much speculation, but Wright in 1906 suggested that they were formed in the bone marrow from megakaryocytes. He concluded that the platelets represented detached bits of cytoplasm of the megakaryocytes.9 There are roughly 100,000 of these platelets formed and destroyed each day, and the entire number in the circulating plasma can be replaced

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