title: Successful Hemostasis with Recombinant Activated Factor VII in a Patient with Massive Hepatic Subcapsular Hematoma.
abstract: 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.
authors.affiliation: Departments of Internal Medicine, Chungbuk National University, Cheongju, South Korea.
authors.forename: Ju-Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Hee Bok
authors.initials: HB
authors.lastname: Chae
authors.forename: Eui-Keun
authors.initials: EK
authors.lastname: Seo
authors.forename: Won Joong
authors.initials: WJ
authors.lastname: Jeon
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Jeong
authors.forename: Yoon Mi
authors.initials: YM
authors.lastname: Shin
authors.forename: Jang Whan
authors.initials: JW
authors.lastname: Bae
authors.forename: Soon Kil
authors.initials: SK
authors.lastname: Kwon
authors.forename: Il Hun
authors.initials: IH
authors.lastname: Bae
authors.forename: Woo Sub
authors.initials: WS
authors.lastname: Shim
authors.forename: Dong Ick
authors.initials: DI
authors.lastname: Shin
authors.forename: Rohyun
authors.initials: R
authors.lastname: Sung
authors.forename: Ji Yoon
authors.initials: JY
authors.lastname: Kim