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

AbstractINTRODUCTION:
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.
AuthorsThorsten Jentzsch, Brigitte Brand-Staufer, Frank P Schäfer, Guido A Wanner, Hans-Peter Simmen
JournalJournal of medical case reports (J Med Case Rep) Vol. 8 Pg. 132 (Apr 30 2014) ISSN: 1752-1947 [Electronic] England
PMID24886030 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Recombinant Proteins
  • recombinant FVIIa
  • Factor VIIa
Topics
  • Aged, 80 and over
  • Compartment Syndromes (etiology, surgery)
  • Factor VIIa (therapeutic use)
  • Hemophilia A (complications, drug therapy)
  • Hemorrhage (complications, drug therapy)
  • Humans
  • Lower Extremity
  • Male
  • Recombinant Proteins (therapeutic use)
  • Treatment Outcome

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