Splenic Rupture in a Newborn With Severe Hemophilia—Case Report and Review

Abstract

Life-threatening splenic rupture is rare in neonates with severe hemophilia. There are only 3 cases of splenic rupture in neonates with hemophilia reported in the literature. We present the case of an infant, born to a hemophilia A carrier mother. The infant was asymptomatic until discharge at 48 hours of age, but presented on the third day of life with shock, abdominal distension, and severe anemia. Computed tomography of the abdomen confirmed the diagnosis of splenic rupture with hemoperitoneum. The infant recovered after extensive supportive care surgery and factor replacement.

Severe Anemia in the Newborn Nursery

“…The underlying cause for the bleeding is highly variable. One case describes maternal trauma prior to delivery as the possible cause for splenic damage, 6 but most cases assume the delivery itself was the inciting event, especially in the case of a traumatic or difficult delivery, 2,7-9 an intrinsic bleeding disorder such as hemophilia A 10-12 or other clinical entities such as a wandering spleen, 13 splenic hemangioendothelioma, 14 and splenomegaly caused by erythroblastosis fetalis. 15 Many cases are idiopathic, 2,4 with no cause identified, such as this case.…”

Acute Life-Threatening Hemorrhage in Neonates With Severe Hemophilia A: A Report of 3 Cases

“…Fortunately, our patient improved and we did not expose him to the surgical complications seen in postoperative splenectomy patients: chylous/infectious ascites, hematuria, pneumonia, and more bleeding. 12 - 14 …”

Neonatal Spleen Rupture, Shock, and Factor Vii Deficiency

“…Splenic rupture in the neonatal period is a rare occurrence, and is seldom reported in the literature [1,2]. Although some cases can be spontaneous, the most common etiology encountered is traumatic [2].…”