“Two birds, one stone”: ITP managed at the time of bariatric surgery

Background: There is a growing prevalence of obesity, with a subsequent increase in bariatric surgeries. As a result, the patient population undergoing surgery has become widely varied with multiple additional medical and surgical problems. Some of those additional problems, on occasions, require surgical management. This can sometimes become tricky and pose a challenge in the decision to proceed safely with an elective bariatric procedure. One such consideration is ITP (idiopathic thrombocytopenic purpura), which, if refractory to medical management requires surgical treatment. Low platelets are known to increase the risk of bleeding complications. Besides chronic anemia, thrombocytopenia has been described as a potential hematological alteration after bariatric surgery and this can understandably create a decision dilemma. Here we present a novel case of a 33 year old lady with medically refractory ITP who underwent surgical management for her ITP along with bariatric surgery, and rather than being a contra-indication for the weight loss procedure, her thrombocytopenia was managed effectively and safely at the same time.