A Novel Use of Tisseel in the Setting of Uncontrolled Bleeding in a Thrombocytopenic Patient With Idiopathic Thrombocytopenia

We present a case of an 87-year-old female who was evaluated for an 8.5 cm left sided renal mass concerning for malignancy. The patient was transiently thrombocytopenic over the previous 4 months with platelet counts ranging from 50,000 to 125,000 plt/mcL and experienced diffuse hemorrhage during radical nephrectomy with failure to achieve mechanical hemostasis or fulguration. Following Surgicel (Ethicon; Somerville, New Jersey) application, we applied Tisseel (Baxter; Deerfield, IL) to the nephrectomy bed with complete hemostasis of bleeding foci. Tisseel saved this thrombocytopenic patient with uncontrolled bleeding and should have this clinical utility recognized.