Abstract Number: PB0954
Meeting: ISTH 2020 Congress
- Hemophilia A is a hereditary hemorrhagic disorder that can cause intra-abdominal bleeding.
- Careful assessment of coagulation must be performed in these patients.
- The administration of the deficient factor is sufficient to resolve the problem, avoiding unnecessary surgeries.
Aims: The aim of the study is to evaluate the efficacy and safety of non-surgical interventions in Hemophilia A patients presenting acute abdominal emergencies.
Methods: This study included 23 Hemophilia A patients (without inhibitors) presenting with acute abdominal pain. All patients were assessed clinically, and unstable patients were admitted in the intensive care unit.
Laboratory workup in the form of CBC, coagulation profile and biochemical profile were done. Imaging workup in the form of Ultrasonography, CT, and MRI were done to evaluate the site, size and extent of the intraabdominal hematomas and to assess the needs for intervention.
Results: Nineteen (82.6%) patients were admitted in the regular medical ward under careful observation, while 4 (17.4%) were admitted to the ICU. Nineteen patients (82.6%) required blood transfusion.
Eleven (47.8%) patients had more than one hematoma while 12 (52.2 %) patients had single hematoma.
Eighteen (78.2%) iliopsoas hematomas; four (17.3%) retroperitoneal collections;
Eight (34.7%) pelvic collections and two (8.7%) perinephric hematomas were encountered.
Ultrasound guided aspiration was done repeatedly in allpatients; total number of procedures were 80. Ultrasound guided pigtail insertion was done in seven patients (30.43%).
Twenty (86.9%) patients underwent complete recovery and were discharged; while three (13.04%) mortalities were encountered due to other comorbidities apart from abdominal catastrophes.
Conclusions: Non-surgical management of Hemophilia A patients presenting with abdominal emergencies could be both safe and effective and it is needed to avoid the problems related to rushed surgical decision or the reluctant surgical behavior specially of limited availability of factor replacementespecially in this high-risk group of patients.
To cite this abstract in AMA style:Abdelkader Morad M, Elkholy M, Mattar M, Hasab Allah M, Ayad A, Habib S, Nashed G. Abdominal Catastrophe in Hemophilic Patients: Towards Wise Decision Making [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/abdominal-catastrophe-in-hemophilic-patients-towards-wise-decision-making/. Accessed September 29, 2023.
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