Intramural Hematoma of the Small Intestine in a Patient with Severe Hemophilia A. Case Report and Review of the Literature

Intestinal subocclusion is a clinical picture characterized by an incomplete interruption of the distal progression of the intestinal contents, and it may be due to multiple causes. We present here the case of a 20-year-old male with severe hemophilia A who developed symptoms of periumbilical abdominal pain and intestinal subocclusion. The CT scan revealed submucosal hemorrhage in the jejunum and dilatation of the proximal segments. A conservative treatment with plasmatic factor VIII was applied and the patient showed good response to the treatment and resolution of the intramural hematoma. With this case we want to highlight this intestinal manifestation of hemophilia, its atypical clinical behavior as intestinal subocclusion and its good response to a conservative treatment with factor VIII, as opposed to surgery as the first therapeutic option. We also offer a review of the last cases of hematomas in the gastrointestinal tract in hemophiliac patients.