An Anesthetic Management of Patient with Hemophilia A Undergoing Recurrent Perianal Abscesses

Abstract

Hemophilia A is an x-linked recessive disorder characterized by an absent or reduced factor VIII (FVIII). It is a genetic deficiency that causes increased bleeding. It can be challenging for anesthesiologists to discover it in the perioperative management. This case report represents the successful management of a 25-year-old male patient having severe hemophilia A. We managed a 25-year-old man, 89 kg, 180 cm, with a recurring history of perianal abscesses. Previously at 13 years old, he experienced prolonged and excessive bleeding after a minor cut and injury. Following clinical and laboratory investigation, he was diagnosed with severe hemophilia A. Ever since, he used to take antihemophilic factor (AHF) VIII transfusion therapy and revealed severe disease with a positive inhibitor. No other coexisting disease was revealed during history-taking. We managed this case with general anesthesia because of the fact that he was hemophilic. We administered 2000 International Unit (IU) of recombinant Factor VIII (rFVIII) preoperatively as per the hematologist’s recommendation. We continued with 2000 IU of AHF FVIII transfusion after the surgery, but unfortunately, he redeveloped the abscess again. Another careful anesthesia and surgery were then conducted with a satisfactory result. The multidisciplinary team approach was provided to a positive outcome in these patients. Perioperative transfusion of AHF FVIII is essential for patients with hemophilia.