Post Circumcision Bleeding due to Undiagnosed Hemophilia: a Case Report

Abstract

Background. Hemophilia is an X-linked recessive bleeding disorder caused by the deficiency of coagulation factors VIII, IX, or XI. In Indonesia, it is estimated that there are 20,000 hemophiliacs out of 270 million population. In about 20% of cases no family history is found, but known when there is spontaneous bleeding that occurs after trauma / surgery. The objective of this study is to describe case of post circumcision bleeding due to undiagnosed hemophilia in primary health care facility. Case. A 5 years old child experienced bleeding seeps for 16 days from circumcision wound performed in primary health care facility. After reoperated in the hospital, the seeps had stopped for a day then seeped again, therefore the patient admitted for third times. There were no history of previous spontaneous bleeding, no family history of bleeding disorders. Physical examination revealed spontaneous bleeding from the circumcision wound (fig. A). Laboratory finding: Haemoglobin = 10.4 g/dL, White Blood Cell = 8.1x10 3 /μL, Haematocrite = 30.7%, Platelets = 413 x10 3 /μL, PPT = 11.4 seconds, APTT = 92.0 seconds. Complete blood count showed normal result and prolonged APTT with normal PPT.