Successful Hemostasis with Recombinant Activated Factor VII in a Patient with Massive Hepatic Subcapsular Hematoma.
Recombinant activated coagulation factor VII (rFVIIa) is known to be effective in the management of acquired deficiencies of factor VII and platelet function defects. But recently, rFVIIa has been successfully used to treat ongoing bleeding in disseminated intravascular coagulopathy (DIC) condition. The patient reported here was suspected to be suffering from toxic hepatitis on admission. After percutaneous liver biopsy, bleeding occurred and did not stop even after right hepatic artery embolization. The patient developed a severe hemorrhage that resulted in hypovolemic shock, hemoperitoneum, and a massive subcapsular hematoma. The patient then developed DIC due to massive transfusion, as well as acute liver necrosis. The patient was given 400 mug/kg of rFVIIa. Recombinant factor VIIa was administered in an attempt to control the bleeding. This stabilized the hemoglobin levels of the patient. The patient gradually recovered in 4 months. In conclusion, this case suggests that rFVIIa can be successfully used for the hemostasis of uncontrolled bleeding in DIC.
Lee
Ju-Hee
JH
Departments of Internal Medicine, Chungbuk National University, Cheongju, South Korea.
Chae
Hee Bok
HB
Seo
Eui-Keun
EK
Jeon
Won Joong
WJ
Jeong
Hye Won
HW
Shin
Yoon Mi
YM
Bae
Jang Whan
JW
Kwon
Soon Kil
SK
Bae
Il Hun
IH
Shim
Woo Sub
WS
Shin
Dong Ick
DI
Sung
Rohyun
R
Kim
Ji Yoon
JY