An unusual complication of ice skating and the emergence of a previously undiagnosed bleeding disorder

Haemophilia. 2006 Sep;12(5):551-4. doi: 10.1111/j.1365-2516.2006.01309.x.

Abstract

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 microg 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.

Publication types

  • Case Reports

MeSH terms

  • Accidental Falls*
  • Blood Coagulation Factors / therapeutic use
  • Child
  • Factor VII / therapeutic use
  • Factor VII Deficiency / diagnosis*
  • Factor VII Deficiency / drug therapy
  • Factor VIIa
  • Gastrointestinal Hemorrhage / drug therapy
  • Gastrointestinal Hemorrhage / etiology*
  • Hematoma / drug therapy
  • Hematoma / etiology*
  • Humans
  • Male
  • Prothrombin Time
  • Recombinant Proteins / therapeutic use
  • Skating*
  • Treatment Outcome

Substances

  • Blood Coagulation Factors
  • Recombinant Proteins
  • Factor VII
  • recombinant FVIIa
  • Factor VIIa