A young girl with constant exotropia was planned for surgery. Thorough preoperative workup was done and the patient underwent strabismus surgery. The girl developed preseptal haematoma on the third postoperative day with marked chemosis and oozing of blood from the conjunctival cul-de-sac. A history of factor XIII (FXIII) deficiency was later revealed by the caretakers. The patient was admitted and fresh frozen plasma was transfused for 5 days along with intravenous tranexamic acid. Orbital ultrasound and CT scan were done to confirm the location of the haematoma. The child improved significantly after 5 days and the proptosis subsided. FXIII deficiency is a rare form of bleeding disorder that is not revealed on routine coagulation profile tests. Fresh frozen plasma and recombinant FXIII are now available for treatment.
- paediatric surgery
- haematology (drugs and medicines)
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Contributors AB took care of the patient from preoperative workup to postoperative care. The patient was operated under the care of AB. He suggested and informed the case to RK, who along with AB and MJ designed the concept for case report. MJ was involved in collection of data, drafting the manuscript of the case report and ensuring all patient details and images to be collected along with proper consent from the patients. AB and RK revised the manuscript and maintained the standards of the manuscript as per BMJ protocols. The final manuscript was approved by all the three authors, that is, MJ, RK and AB. All authors are responsible for the integrity and accuracy of the data provided.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Parental/guardian consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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