Management of severe haemophilia A during surgery: case report

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Abstract

We describe the case of a patient with severe haemophilia A and significant comorbidities who underwent surgery to remove a large intra-abdominal haematoma first diagnosed 12 years previously. The haemophilia team was instrumental in coordinating care, building a strong rapport with surgical and other medical teams to manage bleeding risk with continuous infusion of factor VIII (FVIII). Medical teams adjusted their working hours according to clinical need. Haemophilia nurses were available to offer support at all times, and developed management procedures and educated staff on haemophilia and its treatment. Perioperative complications included a thrombus occluding the right internal jugular vein, infection and paraesthesia. However, surgery was effective and the patient was pleased with the overall outcome. Haemophilia nurses established strong and rewarding relationships with other teams that will enhance the delivery of care in the future.

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  • 2. Neufeld EJ Solimeno L Quon D et al. Perioperative management of haemophilia B: a critical appraisal of the evidence and current practices. Haemophilia 2017; 23: 821–31.

  • 3. Hampshire Hospital NHS Foundation Trust. Haemophilia treatment plan for abdominal surgery. Clinical guidelines: haemophilia and other bleeding disorders. 23 May 2017; ratified 12 March 2018.

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