Erschienen in:
02.02.2018 | Case Report
Successful endoscopic sphincterotomy for choledocholithiasis in a patient with severe hemophilia A and inhibitors
verfasst von:
Ryo Sugiura, Masaki Kuwatani, Kazumichi Kawakubo, Itsuki Sano, Shin Kato, Tomoyuki Endo, Naoya Sakamoto
Erschienen in:
Clinical Journal of Gastroenterology
|
Ausgabe 3/2018
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Abstract
Endoscopic sphincterotomy (ES) is a standard procedure for bile duct stone removal. However, the safety of ES in patients with hemophilia remains unknown. We treated a 46-year-old man who had choledocholithiasis and severe hemophilia A with high-responding inhibitors during immune tolerance induction therapy. Since coagulation factor VIII inhibitors neutralize and inactivate endogenous and exogenous factor VIII, bleeding risk is higher in hemophilia A patients with inhibitors than in those without inhibitors. With adequate pre- and post-procedure monitoring of the clotting factor and supplemented clotting factor, the patient could safely undergo ES without bleeding complications. ES can be also an effective and safe first-line therapy for choledocholithiasis in patients with hemophilia and inhibitors under the condition of appropriate management.