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An unusual complication of ice skating and the emergence of a previously undiagnosed bleeding disorder
Author(s) -
MAINWARING C. J.,
PLEYDELLPEARCE J.,
CHANA J.,
EVANS J.,
ROY A.,
LEWIS H.
Publication year - 2006
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/j.1365-2516.2006.01309.x
Subject(s) - medicine , surgery , complication , abdominal pain , hematoma , vitamin
Summary. We report the case of an 8‐year‐old boy with no prior abnormal bleeding history who presented with severe central abdominal pain following a freak accident at a local ice rink. Clinical examination confirmed a tender periumbilical mass. An ultrasound scan confirmed a large haemorrhagic fluid collection adjacent to the second part of his duodenum that was causing a subacute small‐bowel obstruction. He was found to have a persistently prolonged prothrombin time between 17.3 and 18.1 s but normal liver function tests. There was no suggestion of dietary vitamin K deficiency. Further investigations confirmed factor VII deficiency with levels between 30.4 and 33.6 IU dL −1 . His prothrombin time did not normalize with intravenous vitamin K. He was subsequently treated with three 30 μ g kg −1 body weight doses of novoseven at 4‐h interval and made an excellent recovery. The haematoma virtually resolved completely confirmed by a follow‐up ultrasound scan 3 months after the initial event.