Illustrated operative management of spontaneous bleeding and compartment syndrome of the lower extremity in a patient with acquired hemophilia A: a case report

Journal of Medical Case Reports

Hans-Peter Simmen¹  Guido A Wanner¹  Frank P Schäfer¹  Brigitte Brand-Staufer²  Thorsten Jentzsch¹ 

[1] Division of Trauma Surgery, Department of Surgery, University Hospital Zürich, Rämistrasse 100, 8091 Zürich, Switzerland;Division of Hematology, Department of Internal Medicine, University Hospital Zürich, Zürich, Switzerland

关键词: Operative management;    Lower extremity;    Fasciotomy;    Factor VIII deficiency;    Compartment syndrome;    Acquired hemophilia A;   

Others  :  822079
DOI  :  10.1186/1752-1947-8-132

 received in 2013-08-30, accepted in 2014-02-03,  发布年份 2014

【 摘 要 】

Introduction

Spontaneous bleeding resulting in compartment syndrome at the lower adult leg due to acquired hemophilia A is rare. There are no reports on operative management of this entity.

Case presentation

We present a case of atraumatic compartment syndrome of the lower leg due to acquired factor VIII deficiency, in an 83-year-old Caucasian man of European descent. He was treated surgically with a long and complicated postoperative course after presenting to a community hospital with a 2-day history of increasing pain and swelling in his left lower leg without a previous history of trauma.

Conclusions

Awareness, prompt diagnosis and effective treatment of compartment syndrome caused by a rare bleeding disorder, which is usually acquired by the elderly, is essential and may spare a patient from surgery or even limb loss, if early administration of recombinant factor VIIa is effective. The course of disease in a patient with operative management of spontaneous bleeding, compartment syndrome and acquired hemophilia A may be prolonged. However, an interdisciplinary approach with meticulous surgical treatment and bleeding management with recombinant factor VIIa as well as inhibitor eradication by immunosuppressive treatment can be successful and expensive.

【 授权许可】

   
2014 Jentzsch et al.; licensee BioMed Central Ltd.

【 图 表 】

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