Intramural Hematoma of the Small Intestine in a Patient with Hemophilia A

Kwon, Sung Ho; Park, Young Sook; Seo, Yu Seoung; Ha, Hyung Keun; Lee, Eun Gyn; Choi, Won Wook; Cho, Jeong Soo; Moon, Young Su; Choi, Il Ju; Cho, Sung Bum

Abstract

Hemophilia A is a severe bleeding disorder resulting from the lack of functional blood coagulation factor VIII. Clinically the disease is characterized by frequent spontaneous bleeding into the weight bearing joints, soft tissue and muscle. Intramural gastrointestinal hemorrhage develops as a recognized complication of trauma, anticoagulant therapy, and bleeding diatheses. Spontaneous intramural hemorrhage of the small intestine is uncommon even in patients with hemophilia. A 51-year-old man presented with abdominal pain for 5 days without trauma history. On admission, his plain abdominal X-ray showed gaseous distension of the proximal small bowel loops. An abdominal CT scan and small bowel barium study revealed multisegmental wall thickening and luminal narrowing at the proximal portion of the small bowel. He was improved after adminstration of clotting factor VIII and antibiotics. We report this case with a review of literature.