title: Nonoperative management of delayed splenic rupture in a patient with hemophilia B.
abstract: Nonoperative management of splenic lacerations has become the standard of care in hemodynamically stable patients. The decision to manage a patient nonoperatively is much more difficult when the patient has a known bleeding disorder. There are a few case reports in the literature describing nonoperative management of splenic trauma in children with hemophilia A (factor VIII deficiency), but only one case report of a patient with hemophilia B (factor IX deficiency) and a splenic laceration successfully managed nonoperatively. We present the case of a 13-year-old boy who presented with a grade 4 splenic laceration, acute blood loss anemia, and hypotension that was managed nonoperatively.
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, Memorial Health University Medical Center, Mercer University School of Medicine, Savannah, GA 31404, USA.
authors.forename: N Elizabeth
authors.initials: NE
authors.lastname: Terry
authors.forename: William C
authors.initials: WC
authors.lastname: Boswell
mesh_terms: D000293:Adolescent; D005164:Factor IX / Q000008:administration & dosage; D002836:Hemophilia B / Q000150:complications*; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007022:Hypotension / Q000209:etiology; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage; D012861:Skating / Q000293:injuries*; D013161:Splenic Rupture / Q000150:complications / Q000628:therapy*; D013997:Time Factors
chemical_list: D011994:Recombinant Proteins; D005164:Factor IX