口蓋扁桃摘出後に判明した軽症の血友病A症例

Post-tonsillectomy diagnosis of mild hemophilia: A case report

はじめに

　口蓋扁桃摘出術（以下，扁摘）は，耳鼻咽喉科領域の手術において最も頻度の高い手術の1つであるが，術後合併症として術後出血があり，頻度としては1〜14％と報告されている^1〜3）。今回われわれは，扁摘後の創部の治癒遅延や，繰り返す出血により判明した軽症の血友病Aの症例を経験したので報告する。

　We report the case of a 24-year-old man with mild hemophilia A who presented with delayed wound healing and recurrent bleeding episodes after he underwent tonsillectomy. Preoperative evaluation showed slightly prolonged activated partial thromboplastin time（37.4 s）, and the presence or absence of an episode of difficult hemostasis was confirmed just in case；however, there was no such episode in the patient or family, and tonsillectomy was performed as scheduled. Postoperatively, the patient developed recurrent bleeding accompanied by delayed wound healing and showed an unexpected course. A test for coagulation factors revealed mild congenital hemophilia A.