Multimodal management of late-stage Bockenheimer disease complicated by severe anemia and coagulopathy: a case report

BackgroundBockenheimer disease is a rare subtype of venous malformations that involves all tissue planes of an upper extremity. This condition progresses throughout life and may cause pain, swelling, hematologic complications, and loss of function. Management for Bockenheimer disease remains challenging.Case presentationThis study presents a case of a 14-year-old girl with late-stage Bockenheimer disease complicated by severe anemia and coagulation disorder. The patient underwent anticoagulation therapy initially, followed by sclerotherapy combined with local suture ligation twice, and received anticoagulants and molecular targeted medication on maintenance post-discharge. Follow-up after 9 months demonstrated a marked improvement in the general condition and significant volume reduction in the affected limb. Laboratory test results revealed recovery of anemia and well-controlled coagulopathy. Complications included contracture in the left elbow.ConclusionManagement for Bockenheimer disease requires multimodal therapy, including sclerotherapy, resection, molecular targeted medication, and anticoagulation throughout the entire process. Prompt intervention at an early stage is crucial to the prognosis. Close attention should be paid to the hematologic profiles, especially during the perioperative period.