How we treat: patients with haemophilia undergoing screening colonoscopy

Patient no. 1, a 61-year-old man with mild haemophilia B [factor IX (FIX) 11%], underwent screening colonoscopy. Recombinant FIX (rFIX) concentrate 90 IU kg was infused immediately before the procedure. Three polyps measuring 5–7 mm were found and removed without difficulty using coldsnare technique with the concurrent application of monopolar electrocautery. Diverticula were scattered throughout the sigmoid colon, and small internal haemorrhoids were also identified. No excessive bleeding occurred. Patient no. 2, a 54-year-old man with severe haemophilia A [factor VIII (FVII) <1%], received epsilon-aminocaproic acid (EACA) 2.6 g 1 h before screening colonoscopy. Recombinant FVIII (rFVIII) was available in the endoscopy suite but was not needed during the procedure. No lesion requiring biopsy or removal was identified, and the colonoscopy concluded uneventfully.