Bilateral pneumothorax accompanied by mild deficiency type hemophilia a: report of a case

Hemophilia A is relatively rare and the number of patients with this disorder who undergo surgery is limited. We herein report a surgical case of bilateral pneumothorax accompanied by mild deficiency type of hemophilia A. Although this patient had undergone major surgery at another institution, a diagnosis of hemophilia A had not been made, nor had he noticed unusual bleeding in his daily life. Laboratory studies showed a slight prolongation of the activated partial thromboplastin time. A thoracoscopic operation was performed for bilateral pneumothorax in 1996. After the initial operation, the blood discharge from the right thoracic drainage tube continued. Despite two reoperations, oozing from the chest wall could not be controlled. Finally, the patient had achieved a stable condition with hemothorax encompassing the right thorax. After a diagnosis of hemophilia A was made, we removed any coagulated blood while administering a factor VIII preparation. Clinical and laboratory indications in daily life of mild deficiency type hemophilia A are not manifest in comparison with those of severe or moderate types. It is therefore necessary to consider this disorder in cases of abnormal bleeding at or after operation.