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CASE REPORT
Year : 2018  |  Volume : 3  |  Issue : 1  |  Page : 20-23

When bleeding wins clotting: The surgical dilemma in life-threatening hemothorax in hemophilia


1 Department of General Surgery, St. John's Medical College Hospital, Bengaluru, Karnataka, India
2 Department of Cardiothoracic and Vascular Surgery, St. John's Medical College Hospital, Bengaluru, Karnataka, India
3 Department of Surgical Oncology, St. John's Medical College Hospital, Bengaluru, Karnataka, India

Correspondence Address:
Joseph Sushil Rao
Department of Surgical Oncology, St. John's Medical College Hospital, Bengaluru - 560 034, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jctt.jctt_2_18

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Due to the lack of awareness and poor access to laboratory diagnosis, hemophilia may not be diagnosed preoperatively leading to therapeutic misadventure during surgery. Hence, this congenital bleeding disorder due to Factor VIII deficiency reduces surgical management. We report a 39-year-old gentleman, diagnosed of Factor VIII deficiency who presented to emergency with acute spontaneous left hemothorax and underwent a successful thoracotomy and decortication which saved his life. He is positive for human immunodeficiency virus as well as hepatitis B for which he is on treatment. The management guidelines for thoracic surgery are not addressed to in the World Federation of Hemophilia guidelines, making the management challenging in this scenario. We report this case due to its rarity and emphasize that early recognition with immediate surgical intervention supported with Factor VIII transfusion played an important role in saving life.


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