Treatment of accidental perianal injection of topical thrombin with intravenous antithrombin

Vance G. Nielsen, Samata R. Paidy, Whitney McLeod, Alexandra Fox, Valentine N. Nfonsam

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


While topical thrombin application can markedly improve surgical hemostasis, rapid absorption of thrombin can result in pulmonary embolism and death. We report a case of accidental interstitial infiltration of topical thrombin after hemorrhoidectomy that was treated with administration of human antithrombin and heparin anticoagulation. Except for a marked decrease in antithrombin activity from super normal to normal values, the patient exhibited no laboratory or clinical signs of pulmonary embolism, thrombin mediated consumptive loss of procoagulants, or regional thrombosis. The patient had an uncomplicated recovery without sign of thrombotic morbidity. While it is hoped that such a medical misadventure should not occur, our case may serve as a reference to guide anticoagulant therapy if such a clinical scenario arises.

Original languageEnglish (US)
Pages (from-to)423-425
Number of pages3
JournalJournal of Thrombosis and Thrombolysis
Issue number3
StatePublished - Apr 1 2017


  • Antithrombin
  • Heparin
  • Medical error
  • Topical thrombin

ASJC Scopus subject areas

  • Hematology
  • Cardiology and Cardiovascular Medicine


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