Forearm compartment syndrome due to acquired hemophilia that required massive blood transfusions after fasciotomy:A case report

作     者：Takuya Kameda Takeru Yokota Soichi Ejiri Shin-ichi Konno 

作者机构：Department of Orthopaedic SurgeryFukushima Medical UniversityFukushima 960-1295FukushimaJapan Department of Hand and Limb Reconstructive SurgeryFukushima Medical UniversityFukushima 960-1295FukushimaJapan 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2021年第9卷第31期

页      面：9592-9597页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Acquired hemophilia Compartment syndrome Fasciotomy Bleeding Cost Case report 

摘      要：BACKGROUND Acquired hemophilia is *** some cases,the bleeding in muscle causes compartment ***,it is not clear whether fasciotomy should be performed for the compartment syndrome caused by acquired hemophilia because of the risk of bleeding and the unknown functional *** SUMMARY A 75-year-old woman was admitted with severe pain of the right forearm with no preceding traumatic *** right forearm was obviously swollen,and stretch pain was *** hematomas were suspected in various parts of the *** pressure was 110 mmHg on the volar *** partial thromboplastin time(aPTT)was prolonged to 54.9 *** was performed,and hematoma was observed in the volar *** laboratory examinations revealed a low level of factor Ⅷ(FⅧ)activity(12.5%)and a high level of FⅧ inhibitor(15.2 bethesda units/mL).Acquired hemophilia A was *** recombinant clotting factors were administered,transfusion of red blood cells reached 46 units(140 mL/unit).Hemostasis was achieved 9 d after *** total cost of the clotting factor concentrates administered reached 28834600 *** prednisolone,FⅧ activity and aPTT recovered *** function of the hand was good in the index finger and excellent in the *** Fasciotomy resulted in good function of the hand in a case of non-traumatic compartment syndrome caused by acquired hemophilia,but life-threatening bleeding occurred,and the cost of clotting factor treatment was *** of sufficient blood transfusion,preoperative administration of recombinant activated clotting factor Ⅶ,and prompt fasciotomy could be ideal for such cases.