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Delayed hemorrhage after cervical conization unmasking severe factor XI deficiency
Sarah H Kim1, Sindhu K Srinivas, Stephen C Rubin
1Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA.
Obstetrics and Gynecology
|November 2, 2004
Summary
Factor XI deficiency can cause severe bleeding after surgery. Proper preoperative evaluation and perioperative management are crucial for patients with this rare bleeding disorder.
Area of Science:
- Hematology
- Genetics
- Gynecologic Oncology
Background:
- Factor XI deficiency is a rare inherited bleeding disorder.
- It is most prevalent in individuals of Ashkenazi Jewish descent.
- Patients may present with a history of unusual bleeding after surgical procedures.
Observation:
- A patient of Ashkenazi Jewish heritage experienced severe vaginal bleeding 12 days post-cervical conization.
- The bleeding necessitated multiple transfusions and uterine artery embolization.
- A diagnosis of severe factor XI deficiency was established after extensive evaluation.
Findings:
- Severe factor XI deficiency can manifest as significant bleeding complications following elective surgery.
- The patient required a modified radical hysterectomy for cervical cancer treatment.
- Successful surgical intervention was achieved with appropriate perioperative management.
Implications:
- Highlights the importance of preoperative assessment for factor XI deficiency in at-risk populations.
- Emphasizes the necessity of tailored perioperative strategies to mitigate bleeding risks.
- Informs clinical practice regarding the management of bleeding disorders in gynecologic surgery.