Abstract
Troublesome and unexplained bleeding occasionally occurs in patients during and after surgical procedures. Preoperative evaluation by a careful medical history and physical examination will alert the surgeon to those patients with possible underlying hemorrhagic disease. The widespread use of anticoagulant drugs has multiplied this group. Detailed coagulation studies are warranted only to help diagnose or to indicate the severity of a particular disease in a patient who is a known or prospective bleeder. Specific treatment is available for some bleeding patients with certain diagnoses; in others treatment is only supportive. Some agents advocated in the treatment of bleeding would seem to have little justification for their use. The physician who orders a blood transfusion must be aware of his responsibilities for the incidental morbidity and mortality of this procedure.
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