The Surgical Treatment of Haemophilic Blood Cysts

The treatment of cystic haematomas in patients with haemophilia and Christmas disease is an unsolved problem, and their occurrence can be a danger to life (Macfarlane, Mallam, Witts, Bidwell, Biggs, Fraenkel, Honey and Taylor 1957). Fraenkel, Taylor and Richards (1959), who reported two examples and reviewed the literature, were able to find only one report of a patient who had survived operation. This patient had a cyst of the thumb, which was amputated (Firor and Woodhall 1936). Abell and Bailey (1960) reported nineteen patients, of whom two survived after operation. One further patient has been reported (Egeberg, Borchgrevink and Hjort 1960) who survived disarticulation of the hip for a cystic haematoma of the thigh. Crock and Boni (1960) suggested that radical surgery as an elective procedure might be delayed too long. This paper records successful surgical treatment in two cases, and draws attention to the careful haematological management required afterwards. In the first patient the cyst was excised, and in the second patient the limb which contained the cyst was amputated.