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Case Reports in Orthopedics
Volume 2013, Article ID 473014, 5 pages
Case Report

The Massive Bleeding after the Operation of Hip Joint Surgery with the Acquired Haemorrhagic Coagulation Factor XIII(13) Deficiency: Two Case Reports

1Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Izunagaoka 1129, Izunokuni, Shizuoka 410-2295, Japan
2Department of Orthopaedic Surgery, Juntendo University, Hongou 3-1-3, Bunkyo Tokyo 113-8431, Japan

Received 12 January 2013; Accepted 11 February 2013

Academic Editors: M. G. Lykissas, A. Nehme, S. A. Papadakis, and S. Parekh

Copyright © 2013 Akio Kanda et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Two women, aged 81 and 61, became haemorrhagic after surgery. Their previous surgeries were uneventful with no unexpected bleeding observed. Blood tests prior to the current surgeries indicated normal values including those related to coagulation. There were no problems with the current surgeries prior to leaving the operating room. At 3 hours after the surgery, the 81-year-old patient had an outflow of the drain at 1290 grams and her blood pressure decreased. She had disseminated intravascular coagulation (DIC). The 61-year-old woman had repeated haemorrhages after her current surgery for a long time. Their abnormal haemorrhages were caused by a deficiency of coagulation factor XIII(13). The mechanism of haemorrhagic coagulation factor XIII(13) deficiency is not understood, and it is a rare disorder. The only diagnostic method to detect this disorder is to measure factor XIII(13) activity in the blood. In this paper, we used Arabic and Roman numerals at the same time to avoid confusion of coagulation factor XIII(13) with coagulation factor VIII(8) that causes hemophilia A.