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Use of thromboelastography in the management of liver cirrhosis and accelerated intravascular coagulation and fibrinolysis (AICF)
  1. Thomas Joseph Peterson1,
  2. Allison Margaret Brown Webb2,
  3. Benjamin Samuel Vipler3
  1. 1Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine, Bethesda, Maryland, USA
  2. 2Department of Internal Medicine–Psychiatry, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
  3. 3Department of Internal Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
  1. Correspondence to Thomas Joseph Peterson, tjpeterson09{at}


In the presented case, the authors describe an obese middle-aged man that presented to the emergency department for persistent oedema, scleral icterus and fatigue. He was admitted to the hospital and diagnosed with liver cirrhosis via transjugular liver biopsy. He continued to bleed from the biopsy site for 5 days from accelerated intravascular coagulation and fibrinolysis (AICF) requiring multiple transfusions of packed red blood cells, fresh-frozen plasma and cryoprecipitate. The authors then used thromboelastography (TEG) to further characterise the patient's coagulopathy, which revealed platelet inhibition. The results of the TEG significantly changed future transfusion management. Finally, the authors conducted a literature review to summarise the current literature available for the use of TEG in the management of liver cirrhosis with AICF.

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  • Disclaimer The views expressed in this manuscript are those of the authors and do not necessarily reflect the official policy or position of the Departments of the Army or Navy, Department of Defense, or the United States Government.

  • Contributors TJP wrote the article and reviewed all of the articles in the literature search. BV and AMBW reviewed the articles in the literature search and edited the original manuscript to prepare for submission.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.