Evaluation of coagulation disorders in patients with diseases of Waldeyer's ring.

The presence of pre-existing hemostatic disorders in a surgical patient may pose difficulties in the care of patients during and after surgery. To reduce the risk of excessive hemorrhage, this article has stressed the value of a thorough medical history, physical examination, and appropriate laboratory assays before surgery. When these measures reveal no evidence of a coagulation disorder, the surgeon can have confidence that the patient's hemostatic system has the appropriate resources to prevent excessive bleeding during surgery. However, if the coagulation screening procedure suggests that an abnormality exists, specific diagnostic assays must be performed before any necessary surgery to determine the exact nature of the coagulopathy. When this information is present, specific forms of blood component therapy can be given to minimize the risk of excessive hemorrhage during the operative period.