Successful Hemostasis with Recombinant Activated Factor VII in a Patient with Massive Hepatic Subcapsular Hematoma.

Case Reports in Gastroenterology
Ju-Hee LeeJi Yoon Kim

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.

Citations

Jul 19, 2013·The Journal of Emergency Medicine·Mansour JammalMonica Kapoor
Apr 12, 2012·Acta Anaesthesiologica Scandinavica·R PalmasonP T Onundarson
Mar 7, 2015·The Annals of Thoracic Surgery·Michael JohnsonSalomao Faintuch
Feb 25, 2020·British Journal of Neurosurgery·Guo-Hui HuangDong-Fu Feng
Jan 2, 2020·Internal and Emergency Medicine·Rohit BhoilSabina Bhoil

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