Prevention is essential for avoiding the complications of muscle hematomas (compartment
syndrome, pseudotumous and peripheral nerve lesions) in hemophilic patients. This is achieved
through early diagnosis of muscle hematomas and proper long-term hematological treatment
until they have resolved (confirmed by image studies). Ultrasound-guided percutaneous
drainage could be beneficial in terms of achieving better and faster symptom relief. Acute
compartment syndrome (ACS) requires emergency surgical treatment (decompression
fasciotomy). As for pseudotumor, biopsy will help us confirm the diagnosis and rule out true
tumors (chondrosarcoma, liposarcoma, synovial sarcoma) that sometimes mimic hemophilic
pseudotumour. Surgical removal of hemophilic pseudotumor is the best solution. As
alternatives, there are curettage and filling with cancellous bone and radiotherapy (when surgery
is contraindicated). Preoperative arterial embolization (ideally 2 weeks before surgery) helps
control intraoperative bleeding during surgery for giant pelvic pseudotumor. Peripheral nerve
injuries, which are rare, almost always occur due to compression of hematomas in the vicinity.
In most cases, they usually resolve with hematological treatment only. If such treatment fails,
surgery would be indicated.
Keywords: Antifungal protein, Candida albicans, Colletotrichum sp. DM-06, endophytic fungus, extracellular protein, pathogenic
fungus, Hemophilia, muscle hematomas, pseudotumors, acute compartment syndrome,
peripheral nerve injuries, diagnosis, treatment.
Rights & PermissionsPrintExport