Severe Postoperative Hemorrhage Following Dental Debridement in a Patient With PSPD.

BACKGROUND

Platelet Storage Pool Deficiency (PSPD) is a rare qualitative defect involving impaired granule secretion, often presenting with normal routine coagulation profiles. This case highlights the challenges of dental debridement in a young adult with special health care needs where functional platelet failure outweighs numerical counts.

CASE DESCRIPTION: An 18-year-old required dental debridement under general anesthesia. Despite a multidisciplinary preoperative protocol involving desmopressin and antifibrinolytics, the patient encountered refractory postoperative hemorrhage. The bleeding exceeded the capacity of local hemostatic measures, necessitating an emergent blood transfusion for stabilization.

PRACTICAL IMPLICATIONS: This case underscores that pharmacological management of PSPD can be unpredictable. It reaffirms the necessity of the hospital-based "Medical Home" for special care populations, ensuring immediate access to blood products and interdisciplinary expertise. Practitioners must look beyond standard lab values when planning invasive procedures for patients with qualitative platelet dysfunction.