Splenic rupture in hemophilia.

Purpose: Little information is available regarding splenic injury in patients with hemophilia. We describe here the management of splenic rupture in five of our patients with hemophilia and summarize the literature describing this complication.

Patients and methods: Two human immunodeficiency virus-seropositive patients were managed medically and did not require splenectomy. A third patient had a high titer inhibitor to both porcine and human factor VIII and required emergency splenectomy. Two boys had not been previously diagnosed with hemophilia until they underwent splenectomy after abdominal trauma.

Results: All five patients survived.

Conclusions: These cases demonstrate that nonsurgical management of splenic injury in patients with hemophilia can be performed safely and that splenectomy can be successfully performed despite a high titer of factor VIII inhibitor.