A Case of Hemorrhagic Shock Due to Abdominal Hemorrhage in Hemophilia A: The Role of Laboratory Medicine in Multidisciplinary Team.

BACKGROUND

Spontaneous abdominal hemorrhage due to hemophilia A is one of the most lethal complications, progressing rapidly and potentially leading to hemorrhagic shock or death.

METHODS

We report a case of a 38-year-old male patient with hemophilia A who presented with massive spontaneous abdominal hemorrhage, leading to a large hematoma and severe hemorrhagic shock. Upon admission, the patient showed unstable vital signs and a significant decline in hemoglobin levels, indicating an extremely perilous condition that required immediate multidisciplinary collaborative intervention.

RESULTS

A multidisciplinary team was assembled, including specialists from emergency medicine, intensive care, hematology, cardiothoracic surgery, laboratory medicine, and radiology. The team quickly diagnosed active abdominal hemorrhage and performed successful catheter-directed arterial embolization. Despite ongoing hemoglobin decline after the procedure, the multidisciplinary team employed targeted laboratory monitoring and assessments to identify underlying causes and adjust coagulation factor replacement and transfusion strategies, effectively stabilizing hemoglobin levels. During recovery, the patient developed progressive jaundice, which was determined to be due to the absorption of the large hematoma, thus preventing unnecessary invasive procedures.

CONCLUSIONS

This case underscores the importance of a multidisciplinary approach in managing complex critical conditions and highlights the vital role of laboratory medicine in accurate diagnosis, decision-making, and management of complications.