Hemoperitoneum as a Life-Threatening Complication of an Acute Cholecystitis in a Patient with Hemophilia A with Inhibitors: A Case Report
We present the case of a 52-year-old male with severe hemophilia A with inhibitors, who was diagnosticated with acute lithiasic cholecystitis that required surgical intervention due to lack of favorable response to conservatory treatment. During surgery, hemostatic support was performed with activat...
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MDPI AG
2022-08-01
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| Online Access: | https://www.mdpi.com/2227-9032/10/9/1652 |
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| author | Oana Viola Badulescu Adelina Papancea Nina Filip Bogdan Mihnea Ciuntu Ciprian Cirdeiu Gabriela Bordeianu Dan Vintila Minerva Codruta Badescu Manuela Ciocoiu Stefan Octavian Georgescu |
| author_facet | Oana Viola Badulescu Adelina Papancea Nina Filip Bogdan Mihnea Ciuntu Ciprian Cirdeiu Gabriela Bordeianu Dan Vintila Minerva Codruta Badescu Manuela Ciocoiu Stefan Octavian Georgescu |
| author_sort | Oana Viola Badulescu |
| collection | DOAJ |
| description | We present the case of a 52-year-old male with severe hemophilia A with inhibitors, who was diagnosticated with acute lithiasic cholecystitis that required surgical intervention due to lack of favorable response to conservatory treatment. During surgery, hemostatic support was performed with activated recombinant factor VII (rFVIIa, NovoSeven<sup>®</sup>). The surgery was performed first laparoscopically with adhesiolysis, followed by subcostal laparotomy and cholecystectomy because of the findings of a pericholecystic plastron with abscess and massive inflammatory anatomical modifications. The patient presented postoperative complications, requiring a second surgical intervention, due to the installation of a hemoperitoneum. Hemostatic treatment with rFVIIa was given for a further 3 weeks postoperatively, and the patient was discharged in safe condition. A surgical intervention increases the risk of bleeding in hemophilic patients, which may have vital complications in the absence of adequate hemostatic support and the support of a multidisciplinary team with experience in hemophilic surgery. |
| first_indexed | 2024-03-09T23:54:51Z |
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| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-09T23:54:51Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-ba8c9bdc302e43478e3a5536cfbb6b8f2023-11-23T16:28:30ZengMDPI AGHealthcare2227-90322022-08-01109165210.3390/healthcare10091652Hemoperitoneum as a Life-Threatening Complication of an Acute Cholecystitis in a Patient with Hemophilia A with Inhibitors: A Case ReportOana Viola Badulescu0Adelina Papancea1Nina Filip2Bogdan Mihnea Ciuntu3Ciprian Cirdeiu4Gabriela Bordeianu5Dan Vintila6Minerva Codruta Badescu7Manuela Ciocoiu8Stefan Octavian Georgescu9Department of Pathophysiology, Morpho-Functional Sciences (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of General Surgery, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, RomaniaDepartment of Biochemistry, Morpho-Functional Sciences (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700020 Iasi, RomaniaDepartment of General Surgery, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, RomaniaGeneral Surgery Clinic, “St. Spiridon” County Emergency Clinical Hospital, 1 Independence Boulevard, 700111 Iași, RomaniaDepartment of Biochemistry, Morpho-Functional Sciences (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700020 Iasi, RomaniaDepartment of General Surgery, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, RomaniaDepartment of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Pathophysiology, Morpho-Functional Sciences (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of General Surgery, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, RomaniaWe present the case of a 52-year-old male with severe hemophilia A with inhibitors, who was diagnosticated with acute lithiasic cholecystitis that required surgical intervention due to lack of favorable response to conservatory treatment. During surgery, hemostatic support was performed with activated recombinant factor VII (rFVIIa, NovoSeven<sup>®</sup>). The surgery was performed first laparoscopically with adhesiolysis, followed by subcostal laparotomy and cholecystectomy because of the findings of a pericholecystic plastron with abscess and massive inflammatory anatomical modifications. The patient presented postoperative complications, requiring a second surgical intervention, due to the installation of a hemoperitoneum. Hemostatic treatment with rFVIIa was given for a further 3 weeks postoperatively, and the patient was discharged in safe condition. A surgical intervention increases the risk of bleeding in hemophilic patients, which may have vital complications in the absence of adequate hemostatic support and the support of a multidisciplinary team with experience in hemophilic surgery.https://www.mdpi.com/2227-9032/10/9/1652hemophilia Ableeding disorderscoagulationhemostasis |
| spellingShingle | Oana Viola Badulescu Adelina Papancea Nina Filip Bogdan Mihnea Ciuntu Ciprian Cirdeiu Gabriela Bordeianu Dan Vintila Minerva Codruta Badescu Manuela Ciocoiu Stefan Octavian Georgescu Hemoperitoneum as a Life-Threatening Complication of an Acute Cholecystitis in a Patient with Hemophilia A with Inhibitors: A Case Report Healthcare hemophilia A bleeding disorders coagulation hemostasis |
| title | Hemoperitoneum as a Life-Threatening Complication of an Acute Cholecystitis in a Patient with Hemophilia A with Inhibitors: A Case Report |
| title_full | Hemoperitoneum as a Life-Threatening Complication of an Acute Cholecystitis in a Patient with Hemophilia A with Inhibitors: A Case Report |
| title_fullStr | Hemoperitoneum as a Life-Threatening Complication of an Acute Cholecystitis in a Patient with Hemophilia A with Inhibitors: A Case Report |
| title_full_unstemmed | Hemoperitoneum as a Life-Threatening Complication of an Acute Cholecystitis in a Patient with Hemophilia A with Inhibitors: A Case Report |
| title_short | Hemoperitoneum as a Life-Threatening Complication of an Acute Cholecystitis in a Patient with Hemophilia A with Inhibitors: A Case Report |
| title_sort | hemoperitoneum as a life threatening complication of an acute cholecystitis in a patient with hemophilia a with inhibitors a case report |
| topic | hemophilia A bleeding disorders coagulation hemostasis |
| url | https://www.mdpi.com/2227-9032/10/9/1652 |
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