Conservative treatment of hemophiliac bleeding

: Since the introduction of home-care replacement therapy for hemophilic patients, life-endangering spontaneous bleeding is rare. We describe a 15-year-old boy with severe hemophilia, who without antecedent trauma developed massive abdominal bleeding and hemothorax, leading to hypovolemic shock. Although an operation was advised, intensive conservative replacement therapy and drainage of the thorax led to complete recovery. We stress that in the absence of acute trauma, bleeding due to hemophilia consists of oozing, so conservative treatment is recommended.