A case of pancreatic walled-off necrosis successfully treated with endoscopic ultrasonography-guided drainage using Hot AXIOS System in a patient with severe hemophilia A

Background Hemophilia A causes a bleeding tendency due to the congenital absence of coagulation factor VIII or the production of antibodies against it. It is challenging to perform invasive procedures in patients with hemophilia A. Walled-off necrosis (WON) is a serious complication of acute pancrea...

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Bibliographic Details
Published in:Clinical journal of gastroenterology 2022-02, Vol.15 (1), p.216-220
Main Authors: Morita, Ryuichi, Doi, Toshifumi, Ishikawa, Takeshi, Fukuma, Taito, Sato, Hideki, Ohshiro, Muneo, Yasuda, Hiroaki, Konishi, Hideyuki, Naito, Yuji, Itoh, Yoshito
Format: Article
Language:English
Subjects:
Abdominal Surgery
Acute Disease
Adult
Case Report
Colorectal Surgery
Drainage - methods
Endosonography - methods
Gastroenterology
Hemophilia A - complications
Hepatology
Humans
Male
Medicine
Medicine & Public Health
Necrosis
Pancreatitis
Retrospective Studies
Stents
Surgical Oncology
Treatment Outcome
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Summary:Background Hemophilia A causes a bleeding tendency due to the congenital absence of coagulation factor VIII or the production of antibodies against it. It is challenging to perform invasive procedures in patients with hemophilia A. Walled-off necrosis (WON) is a serious complication of acute pancreatitis. Recently, a new metallic stent has been used to drain WON. Clinical course We treated a 32-year-old man who developed WON due to acute pancreatitis and has severe congenital hemophilia A. Since conservative treatment was ineffective, he underwent endoscopic ultrasonography (EUS)-guided transgastric WON drainage using a new metallic stent Hot AXIOS System. The procedure was successful without any severe hemorrhagic complications. Before and after the procedure, his clotting factors were strictly monitored by a hemophilia specialist. Conclusion EUS-guided pancreatic cyst drainage can be an effective option for WON in patients with severe congenital hemophilia, under adequate management.
ISSN:1865-7257
1865-7265
DOI:10.1007/s12328-021-01528-x