Bilal Ege, Abdüssamed Geyik, Mustafa UTKUN

Hemofili A Tanısı Almış Bir Hastada Meydana Gelmiş Odontojenik Apsenin Tedavisi: Olgu Sunumu

Hemofili A koagülasyon proteini olan faktör VIII eksikliği veya fonksiyon bozukluğu ile karakterize kalıtsal hemorajik bir bozukluktur. Bu eksiklik yaralanma, diş çekimi ve cerrahi işlemler sonrası uzamış kanamalara ve gecikmiş yara iyileşmesine neden olur. Bu raporda; Hemofili A tanısı almış hastada, uygulanan medikal tedavilere rağmen tekrarlayan submandibular apse ve tedavisi sunulmaktadır. Olgumuz; 23 yaşındaki erkek hasta olup sağ tarafında yüzünde ve boynunda gelişen şişlik ve ağrı şikayetiyle kliniğimize başvurmuştur. Alınan anamnezinde hastanın ilk önce kulak burun boğaz kliniğine başvurduğu, buradaki tedavisini takiben şikayetlerinin tekrarlaması üzerine tarafımıza yönlendirildiği öğrenilmiştir. Yapılan klinik ve radyografik muayenesinde, apsenin sağ alt yirmi yaş dişinden kaynaklı olduğu tespit edilmiş ve dişin çekimi uygun görülmüştür. Hastaya işlem yapılmadan önce hematoloji uzmanıyla konsülte edilerek, hastaya işlem gününe kadar 3 gün süreyle antibiyotik, ağrı kesici ve kas gevşetici ilaç tedavisi uygulanarak ağız açıklığının artırılması sağlandı. İşlem günü hematolog tarafından hastaya faktör VIII yüklemesi yapılan hastada yirmi yaş dişi çekildi ve yara yeri süture edilerek kapatıldı. Postoperatif yapılan kontrollerde herhangi bir kanama veya iyileşmeyle ilgili problemi saptanmadan yara yeri iyileşti. Sonuç olarak; Hemofili A hastalığı hayati tehlike ihtiva edebilen önemli bir sistemik hastalıktır. Bu tanıyı almış hastalarda cerrahi işlemler hematoloğun kontrolünde en uygun steril şartlarda uygun kan değerleri sağlanarak yapılmalıdır.

Anahtar Kelimeler:

Hemofili, faktör VIII, diş çekimi, odontojenik apse, kanama

Treatment of Odontogenic Abscess in a Patient with Hemophilia A: Case Report

Haemophilia A is hereditary haemorrhagic disorders characterised by deficiency or dysfunction of coagulation protein factor VIII. This deficiency causes prolonged bleeding and delayed wound healing after injury, tooth extraction and surgical procedures. In this report; the patient was diagnosed with Hemophilia A and recurrent submandibular abscess despite of its medical treatments was presented. A 23-year-old male patient presented to our clinic with complaints of swelling and pain on the right side of his face and neck. In his anamnesis, it was learned that the patient first applied to the otolaryngology clinic, and after his treatment, were directed to our clinic, because of his recurrent complaints. In the clinical and radiographic examination, it was found that the abscess was caused by the right mandibular wisdom tooth and it was decided to be extracted. Firstly, the patient was consulted with a hematologist before the procedure was performed, and the patient was provided with antibiotic, analgesic and muscle relaxant medication for 3 days until the day of treatment. On the day of the procedure, factor VIII was transfused to the patient by the hematologist and than the wisdom teeth extracted and the wound was closed by suturing. Postoperatively, the wound was healed without any bleeding or healing problem. As a result; Hemophilia A disease is an important systemic disease that can be life-threatening. In these patients, surgical procedures should be performed by providing appropriate blood values in the most appropriate sterile conditions in the control of hematologist.

Keywords:

Hemophilia, factor VIII, tooth extraction, odontogenic abscess, bleeding,

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