Case Report: A Large Spontaneous Abdominal Bruise in a 60-Year-Old Woman

Objective: To report a case of severe abdominal bruising successfully diagnosed using systematic hemostatic investigations. Clinical Presentation and Intervention: A 60-year-old woman developed a large spontaneous nontraumatic, painless bruise over the right lower abdominal wall. Computed tomographic scan of the abdomen showed a subcutaneous hematoma beneath the site of the obvious bruise diagnosed as a hematoma. Laboratory tests revealed an activated partial thromboplastin time of 53 s and a factor VIII level of 1%, consistent with the diagnosis of acquired hemophilia A. The patient was treated with steroids and immunosuppressants and her factor VIII levels gradually normalized. Conclusion: This case report showed that whenever there is spontaneous bruising, factor VIII deficiency should be considered as one of the important differential diagnosis.