抜歯窩が上顎洞と交通し出血をきたした血友病Aの1例 A case of bleeding after dental extraction in a patient with hemophilia A who had an oro-sinusal communication in a dental socket
Dental extraction in patients with hemophilia is associated with a high risk of bleeding after surgery. We report a case of bleeding after dental extraction in a patient with hemophilia A. A 65-year-old man with hemophilia A was referred to our department because of gingival hemorrhage. Oral examination revealed gum disease in the region around the upper left second molar. Both a panoramic radiograph and computed tomographic scans showed a cyst-like radiolucent bone defect at the apex of the upper right first molar. One year later, he had 4 teeth extracted under general anesthesia after infusion of 2000 units of factor VIII concentrate. Extraction of the upper right first molar triggered the formation of an oro-sinusal communication. The dental sockets were filled with surgicel, and a hemostatic splint was used. Postoperatively, 1500 units of factor VIII concentrate was infused once daily for 5 days. On postoperative days 5 and 11, bleeding from the upper right first molar extraction site was stopped by administration of tranexamic acid and local hemostasis. No bleeding occurred in the socket of the upper left second molar. The oro-sinusal communication significantly interferred with local hemostasis.
日本口腔外科学会雑誌 52(10), 560-564, 2006-10-20
Japanese Society of Oral and Maxillofacial Surgeons