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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Dec 16, 2025; 17(12): 114836
Published online Dec 16, 2025. doi: 10.4253/wjge.v17.i12.114836
Published online Dec 16, 2025. doi: 10.4253/wjge.v17.i12.114836
Repeated hemorrhagic ulcers of the esophagus associated with acquired hemophilia A: A case report
Makoto Saito, Emi Yokoyama, Minoru Kanaya, Koh Izumiyama, Akio Mori, Masanobu Morioka, Takeshi Kondo, Blood Disorders Center, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
Kencho Miyashita, Department of Gastroenterology, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
Masahiro Ieko, Department of Nursing, Faculty of Health and Medical Sciences, Sapporo University of Health Sciences, Sapporo 007-0894, Hokkaido, Japan
Author contributions: Saito M designed this study and wrote the manuscript; Saito M, Miyashita K, Ieko M, Yokoyama E, Kanaya M, Izumiyama K, Mori A, Morioka M, and Kondo T contributed to the analysis and interpretation of the data; Saito M, Yokoyama E, and Kondo T primarily decided on the treatment strategy; Miyashita K was involved in the endoscopic procedure in this patient. All authors took part in drafting the article and agree to be accountable for all aspects of the work.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Makoto Saito, Chief Physician, Blood Disorders Center, Aiiku Hospital, Chuo-ku Minami 4 Nishi 25, Sapporo 064-0804, Hokkaido, Japan. ikyoku@aiiku-hp.or.jp
Received: September 29, 2025
Revised: October 18, 2025
Accepted: November 13, 2025
Published online: December 16, 2025
Processing time: 78 Days and 3 Hours
Revised: October 18, 2025
Accepted: November 13, 2025
Published online: December 16, 2025
Processing time: 78 Days and 3 Hours
Core Tip
Core Tip: Acquired hemophilia A can cause life-threatening, severe bleeding. Most cases are characterized by subcutaneous or intramuscular bleeding, whereas gastrointestinal hemorrhage is rare. We report the case of a 76-year-old woman with AHA who presented with repeated bleeding from an esophageal ulcer. Endoscopic hemostasis using radiofrequency ablation was performed seven times; however, this procedure was unsuccessful. First, a mixture of factors VIIa and X (a bypass hemostatic agent) was administered, successfully controlling the hemorrhage from the esophageal ulcer. In addition, emicizumab (a substitute for activated factor VIII) was administered, after which no further bleeding was observed.