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April 4, 1959


Author Affiliations


From the Department of Surgery, Harvard Medical School, and the Surgical Services, Massachusetts General Hospital.

JAMA. 1959;169(14):1623-1625. doi:10.1001/jama.1959.73000310006015b

Despite the diversity of hemorrhagic complications encountered in patients with hemophilia, bleeding within the chest is uncommon. In 1943, review of the early literature by Freedman and associates1 revealed only two cases of hemorrhagic disease complicated by hemothorax; neither patient was a hemophiliac. These authors reported a 22-year-old man with a familial history and laboratory studies characteristic of hemophilia, whose spontaneous hemothorax was treated successfully by repeated thoracenteses and "numerous small transfusions." A similar case had been reported by Pendergrass and Neuhauser2 the year before. In 1957, Kay and Kupfer3 reported a spontaneous hemothorax in a proved hemophiliac successfully treated by thoracenteses and infusions of antihemophilic globulin.

In 1953, in the Polish literature, Juszczynski4 reported a stab wound of the chest successfully treated by thoracotomy in a presumed hemophiliac. The response of this patient to stored bank blood suggests that this was actually a case of