Hemophilia A is relatively rare and the number of patients with this disorder who undergo surgery is limited. We herein report a surgical case of bilateral
pneumothorax accompanied by mild deficiency type of
hemophilia A. Although this patient had undergone major surgery at another institution, a diagnosis of
hemophilia A had not been made, nor had he noticed unusual
bleeding in his daily life. Laboratory studies showed a slight prolongation of the activated partial thromboplastin time. A thoracoscopic operation was performed for bilateral
pneumothorax in 1996. After the initial operation, the blood discharge from the right thoracic drainage tube continued. Despite two reoperations, oozing from the chest wall could not be controlled. Finally, the patient had achieved a stable condition with
hemothorax encompassing the right thorax. After a diagnosis of
hemophilia A was made, we removed any coagulated blood while administering
a factor VIII preparation. Clinical and laboratory indications in daily life of mild deficiency type
hemophilia A are not manifest in comparison with those of severe or moderate types. It is therefore necessary to consider this disorder in cases of abnormal
bleeding at or after operation.