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Successful emergency resection of a massive intra-abdominal hemophilic pseudotumor

查看全文 作　　者：Julie [1]Frezin;Lancelot [1]Marique;Laurent [1]Coubeau;Catherine [1]Hubert;Catherine [2]Lambert;Cédric [2]Hermans;Nicolas [1]Jabbour 高影响力作者 机构地区：[1]Department of Abdominal Surgery and Transplantation, Cliniques Universitaires Saint-Luc;[2]Department of Hematology, Cliniques Universitaires Saint-Luc高影响力机构 出　　处：《World Journal of Gastrointestinal Surgery》索引2015年第7卷第3期,共4页高影响力期刊 摘　　要：An intra-abdominal pseudotumor is a rare complication of hemophilia. Surgical treatment is associated with high morbidity and mortality rates and reported cases are scarce. We present a 66-year-old Caucasian male suffering from severe hemophilia type A treated for 10 years with Factor Ⅷ. Major complications from the disease were chronic hepatitis B and C, cerebral hemorrhage and disabling arthropathy. Twenty-three years ago, retro-peritoneal bleeding led to the development of a large intra-abdominal pseudotumor, which was followed-up clinically due to the high surgical risk and the lack of clinical indication. The patient presented to the emergency department with severe sepsis and umbilical discharge that had appeared over the past two days. Abdominal computed tomography images were highly suggestive of a bowel fistula. The patient was taken to the operating room under continuous infusion of factor Ⅷ. Surgical exploration revealed a large infected pseudotumor with severe intra-abdominal adhesions and a left colonic fistula. The pseudotumor was partially resected en bloc with the left colon leaving the posterior wall intact. The postoperative period was complicated by septic shock and a small bowel fistula that required reoperation. He was discharged on the 73 rd hospital day and is well 8 mo after surgery. No bleeding complications were encountered and we consider surgery safe under factor Ⅷ replacement therapy. 关 键 词：HEMOPHILIA A Hemophilic PSEUDOTUMOR COLONIC FISTULA Factor Ⅷ replacement therapy Surgeryin hemophilic patient
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