Perioperative Care of the Patient With Hemophilia Undergoing Urgent Appendectomy

Redwine, Jonathon

doi:10.1001/archsurg.142.9.894

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…[ 5 , 6 ] But with severe hemophilia A, few reports discussed the treatment of acute appendicitis for this specific group of patients. [ 7 ] Here, we describe a case of 2-incision LA in a child patient with severe hemophilia A and coagulation factor VII deficiency.…”

Section: Introductionmentioning

confidence: 99%

Two-incision laparoscopic appendectomy for a severe hemophilia A child patient with coagulation factor VII deficiency

Feng²

2017

Medicine

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Rationale:The main complication of patients with severe hemophilia is recurrent bleeding events that usually affected musculoskeletal contractures. And replacement therapy methods were continuously improved to minimize adverse impacts brought by those complications. However, only several cases reported about the appendectomy for hemophilia A. We report a case of acute appendicitis treated by two-incision laparoscopy in a boy with hemophilia A and coagulation factor VII deficiency for the first time.Patient concerns:An 8y7m-old Chinese boy presented with half a day of right sided abdominal pain, fever, nausea, and vomiting.Diagnoses:He received a computed tomography (CT) scan which revealed an enlarged appendix, thickened wall and appendiceal fecalith, and had received a conservative anti-bacterial treatment for his acute appendicitis but failed. He was diagnosed with hemophilia A and coagulation factor VII deficiency.Interventions:Two-incision laparoscopic appendectomy was made in success with a careful management of perioperative period. We monitored the clotting factor FVIII level and gave him a replacement therapy.Outcomes:The patient had an uneventful recovery.Lessons:It is important to exclude intraabdominal or retroperitoneal hemorrhage in patients suffering from hemophilia and acute abdominal pain. Pre-operative evaluation of validity of the FVIII replacement therapy is another effective strategy to assess the safety and feasibility of applying an operation procedure. The two-incision laparoscopic appendectomy is an effective treatment for this kind of patients for its minimal trauma and fast recovery characteristics. Our report shows that laparoscopic appendectomy is feasible in a child suffering from hemophilia after adequate blood clotting factor replacement treatment.

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Section: Introductionmentioning

confidence: 99%

Two-incision laparoscopic appendectomy for a severe hemophilia A child patient with coagulation factor VII deficiency

Feng²

2017

Medicine

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“…This coagulopathy is caused by a factor VIII deficiency that manifests as spontaneous bleeding of the joints and tissues, including those forming the digestive and nervous systems [2]. These patients may develop conditions that require surgical treatment, whether they are related to the underlying pathology or to another disorder [3].Haemorrhagic complications in the small or large intestine may simulate an acute surgical abdomen, causing a potential increase in morbidity and mortality [4].…”

Section: Introductionmentioning

confidence: 99%

Acute abdomen in a patient with haemophilia A: A case study

Batista

Silveira²,

Neto

et al. 2015

Int Arch Med

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Background: Haemophilia A is a hereditary haemorrhagic disorder that can cause bleeding in the intestinal loops and, on rare occasions, simulate an acute surgical abdomen. Careful assessment of coagulation must be performed in these patients, followed by an attempt to correct the dysfunctions. Often, the administration of the deficient factor is sufficient to resolve the problem, avoiding unnecessary surgeries. Case report:We present a male patient, 15-years-old, of indigenous descent, who was a diagnosed with haemophiliaA. The young manwas admitted with abdominal pain in the right iliac fossa; ultrasonography suggested acute appendicitis. He underwent an exploratory laparotomy that revealed a normal appendix and the presence of a caecal wall haematoma, without other abnormalities. Conclusion:This case describes an unusual instance of decompensation of a patient with haemophilia A that simulated an acute surgical abdomen. The case suggests the need for further evaluation of carriers of coagulopathies, whether acquired or congenital, when they suffer abdominal pain. Otherwise, clinically treatable dysfunctions are prone to surgical treatment, with a potential for increased morbidity and mortality.

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“…A continuous infusion provides constant therapeutic levels with less total use of recombinant factor VIII. [7] In this patient, factor VIII concentrate was given as bolus injection twice daily. Even if he had mild hemophilia, 100% factor VIII activity was maintained as there was previous history of bleeding following tooth extraction.…”

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confidence: 99%

Perioperative management of a patient with hemophilia A and crigler-najjar syndrome

Bhoi

Kashyap

2013

J Anaesthesiol Clin Pharmacol

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Perioperative Care of the Patient With Hemophilia Undergoing Urgent Appendectomy

Cited by 6 publications

References 12 publications

Two-incision laparoscopic appendectomy for a severe hemophilia A child patient with coagulation factor VII deficiency

Two-incision laparoscopic appendectomy for a severe hemophilia A child patient with coagulation factor VII deficiency

Acute abdomen in a patient with haemophilia A: A case study

Perioperative management of a patient with hemophilia A and crigler-najjar syndrome

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