We report a case of a patient with severe postoperative bleeding complication, secondary to dietary and herbal supplements induced platelet dysfunction. This case demonstrates the importance of preoperative assessment which includes questioning the patient with regards to their dietary and herbal supplements and of stressing the importance of discontinuing them prior to surgery.
AbdulMIJiangXWilliamsKMet al2010Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjectsBritish Journal of Clinical Pharmacology69 (5) 508–515
2.
AllisonGLLoweGMRahmanK2006Aged garlic extract and its constituents inhibit platelet aggregation through multiple mechanismsJournal of Nutrition136 (3Suppl) 782S–788S
3.
BeckertBWConcannonMJHenrySLet al2007The effect of herbal medicines on platelet function: An in vivo experiment and review of the literaturePlastic and Reconstructive Surgery120 (7) 2044–2050
4.
BurnhamBE1995Garlic as a possible risk for postoperative bleedingPlastic and Reconstructive Surgery95 (1) 213
5.
FreedmanJEKeaneyJFJr2001Vitamin E inhibition of platelet aggregation is independent of antioxidant activityJournal of Nutrition131 (2) 374S–377S
6.
GermanKKumarUBlackfordHN1995Garlic and the risk of TURP bleedingBritish journal of Urology76 (4) 518
7.
GuerreroJALozanoMLCastilloJet al2005Flavonoids inhibit platelet function through binding to the thromboxane A2 receptorJournal of Thrombosis and Haemostasis3 (2) 369–376
8.
HarrisWS2007Expert opinion: Omega-3 fatty acids and bleeding: Cause for concern?American Journal of Cardiology99 (6A) S44–S46
9.
HuangCGChuZLWeiSJet al2002Effect of berberine on arachidonic acid metabolism in rabbit platelets and endothelial cellsThrombosis Research106 (4-5) 223–227
10.
LeakJA2000Herbal medicines: What do we need to know?American Society of Anesthesiologists Newsletter64(2)6–7
11.
LeeWMKimSDParkMHet al2008Inhibitory mechanisms of dihydroginsenoside Rg3 in platelet aggregation: Critical roles of ERK2 and cAMPJournal of Pharmacy and Pharmacology60 (11) 1531–1536
12.
LiXLSteinerM1990Fish oil: A potent inhibitor of platelet adhesivenessBlood76 (5) 938–945
LynchGM2003Herbal medicines in the United KingdomAnaesthesia58 (10) 1025
15.
McewenBJ2015The influence of herbal medicine on platelet function and coagulation: a narrative reviewSeminars in Thrombosis and Hemostasis41 (3) 300–314
16.
MousaSA2010Antithrombotic effects of naturally derived products on coagulation and platelet function In: SAMousa (ed) Anticoagulants, antiplatelets and thrombolyticsTotowa, NJ,
Humana Press
17.
PruthiRKSchmidtKASlabyJAet al2007Platelet dysfunction induced by herbal supplements in a patient with mild hemophilia AJournal of Thrombosis and Haemostasis5 (12) 2556–2558
18.
RahmanKBillingtonD2000Dietary supplementation with aged garlic extract inhibits ADP-induced platelet aggregation in humansJournal of Nutrition130 (11) 2662–2665
19.
RoseKDCroissantPDParliamentCFet al1990Spontaneous spinal epidural hematoma with associated platelet dysfunction from excessive garlic ingestion: A case reportNeurosurgery26 (5) 880–882
20.
SchurksMGlynnRJRistPMet al2010Effects of vitamin E on stroke subtypes: Meta-analysis of randomised controlled trialsBritish Medical Journal341c5702
21.
SkinnerCMRangasamiJ2002Preoperative use of herbal medicines: A patient surveyBritish Journal of Anaesthesia89 (5) 792–795
22.
SteinerMLiW2001Aged garlic extract, a modulator of cardiovascular risk factors: a dose-finding study on the effects of AGE on platelet functionsJournal of Nutrition131 (3s) 980S–984S
23.
TawataMYodaYAidaKet al1990Anti-platelet action of GU-7, a 3-arylcoumarin derivative, purified from glycyrrhizae radixPlanta medica56 (3) 259–263
24.
WangC-ZMossJYuanC-S2015Commonly used dietary supplements on coagulation function during surgeryMedicines (Basel)2 (3) 157–185
25.
WilliamsJCForsterLATullSPet al1997Dietary vitamin E supplementation inhibits thrombin-induced platelet aggregation, but not monocyte adhesiveness, in patients with hypercholesterolaemiaInternational Journal of Experimental Pathology78 (4) 259–266
26.
WoodburyASniecinskiR2016Garlic-induced surgical bleeding: How much Is too much?Anesthesia and Analgesia Case Reports7 (12) 266–269
