A 29-year-old man suspected of having a hematopoietic malignancy was scheduled to undergo video- assisted splenectomy. Because of his good general con- dition on a preanesthetic evaluation, combined general and epidural anesthesia was selected. However, after insertion of an epidural catheter in the operating room, surgery had to be postponed due to bleeding from the catheter insertion site. The hematological examination done right after the postponement revealed hemo- phagocytic syndrome and the patient rapidly developed disseminated intravascular coagulation. This case suggested that in a patient with hematopoietic malig- nancy a hematological examination should be carried out on the day of surgery; besides, neuraxial blockade should be avoided because bleeding could be acutely induced due to changes in the patient's condition.
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