SPONTANEOUS HEMOPNEUMOTHORAX IN A HEMOPHILIAC

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