One case of secondary bleeding repeatedly after tonsillectomy. Secondary bleeding after tonsillectomy seldom happen to us. When the event occurs medical staff has to take effect way to control the bleeding immediately. Accumulated quantity of bleeding must be controlled to the lowest point as soon as possible. Other wise the bleeding may lead to death. This point should be considered by medical staff.
Humans ; Postoperative Hemorrhage ; etiology ; Tonsillectomy ; adverse effects

Total hip arthroplasty (THA) is a vital therapeutic tool for hip terminal disease. Frequently, hidden blood loss exists in the postoperation, which seriously affect the postoperative rehabilitation of patients. It is urgent need to solve the problem that how to fundamentally prevent and reduce hidden blood loss after THA. Although THA has its own operational reason in blood loss, and also relates to a variety of risk factors, the mechanism of hidden blood loss is not clear. Tranexamic acid has a significant role in preventing perioperative blood loss, and the correlation of hidden blood loss and fibrinolytic mechanism would be confirm necessarily in the future,which will produce positive significance in completing the mechanism of hidden blood loss.
Arthroplasty, Replacement, Hip ; adverse effects ; Humans ; Postoperative Hemorrhage ; etiology

Cerebral Hemorrhage ; etiology ; Cerebrospinal Fluid Rhinorrhea ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Hemorrhage

A 11-year-old child diagnosed as chronic tonsillitis and adenoid hypertrophy underwent adeno-tonsillectomy under general anesthesia. After surgery, patient complained with abdominal discomfort, paleness and vomiting, which presented as the old black contents. Complete blood count showed: 45.2 g/L, hemoglobin of red blood cells 2.57 x 10(12)/L, An emergency gastroscopy confirmed gastric ulcer with hemorrage. Hemorrage was controlled and complete blood count results restored to normal after supportive therapy. Gastric ulcer completely recovered two weeks after discharge.
Adenoidectomy ; Child ; Humans ; Male ; Peptic Ulcer Hemorrhage ; etiology ; Postoperative Complications ; Stomach Ulcer ; etiology ; Tonsillectomy

Acupuncture Therapy ; Acute Disease ; Fatal Outcome ; Hemorrhage/mortality* ; Humans ; Needles/adverse effects* ; Pharynx/injuries* ; Postoperative Complications ; Postoperative Hemorrhage/etiology*

Aged ; Cause of Death ; Humans ; Laryngeal Neoplasms ; mortality ; Male ; Peptic Ulcer Hemorrhage ; etiology ; mortality ; Postoperative Period

OBJECTIVETo analyze the features, causes, treatments and outcomes of severe gastrointestinal (GI) bleeding after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODSFifteen patients suffered from massive GI bleeding (blood loss leading to hemorrhagic shock) or subacute GI bleeding (at least 1 or more units of red blood cell transfusion on each of two consecutive days) were observed and analyzed after allo-HSCT.

RESULTSSeventeen severe GI bleeding episodes occurred in 15 patients. The severe bleeding occurred in three periods of time: within 1 week, 1 to 2 months and 4 to 7 months after transplantation. The main manifestation was hematemesis and hematochezia in the first period, and hematochezia alone in the second and third periods. Platelet counts at the onset of severe bleeding were < or = 50 x 10(9)/L in the majority of patients. Causes of bleeding were conditioning regimen-related toxicity in 2 patients/episodes, graft versus host disease (GVHD) or/and intestinal cytomegalovirus (CMV) or fungal infections in 11 patients/12 episodes, intestinal CMV infections in 1 patient/episode, acid-peptic ulcer in 2 patients/episodes, and cause unknown in 1 patient/episode. Supportive care such as transfusions of platelet, red blood cell and fresh frozen plasma, H2 receptor blockers and omeprazole were given to all patients, immunosuppressive drugs to patients developed GVHD and antiviral drugs to patients with complicated CMV infection. Eight patients/9 episodes of bleeding were controlled. Eight patients continued severe GI bleeding and died of acute GVHD or related serious complications.

CONCLUSIONSSevere GI bleeding after allo-HSCT are mainly caused by regimen-related toxicity, GVHD or/and intestinal CMV infection. Bleeding caused by conditioning regimen-related toxicity is self-limited and has a better prognosis. However, treatment failure and mortality are high if the patient's bleeding resulted from GVHD and intestinal CMV infection.

Gastrointestinal Hemorrhage ; etiology ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans ; Postoperative Complications ; therapy ; Prognosis

BACKGROUNDBecause of the complexity and severity of the surgery and its associated complications, pancreaticoduodenectomy (PD) is associated with significant morbidity and mortality, especially the hemorrhage post-PD. Exploring the factors associated with post-PD hemorrhage is very important for the patients' safety.

METHODSClinical data from 303 cases of PD between January 1998 and December 2008 were analyzed retrospectively.

RESULTSThe overall mortality rate was 4.95% (15/303). However, post-operative bleeding occurred in 25 patients (8.25%) with nine episodes resulting in death (36.00%). Univariate analysis was performed and identified tumor size, Child's classification, total pancreatic uncinatic process resection, and pancreatic leakage as significant risk factors for post-PD hemorrhage. In the severe hemorrhage group, incomplete resection of uncinate process of pancreas and pancreatic leakage were the main causes. The multivariate Logistic regression analysis revealed that each of these variables is an independent risk factor.

CONCLUSIONSPrimary prevention of bleeding complications depends on total pancreatic uncinatic process resection and meticulous hemostatic techniques during surgery. In addition, several peri-operative factors were found to contribute to post-PD bleeding.

Female ; Humans ; Male ; Middle Aged ; Pancreaticoduodenectomy ; adverse effects ; mortality ; Postoperative Hemorrhage ; etiology ; Risk Factors

OBJECTIVETo analyze the causes and clinical features of gastrointestinal hemorrhage following pancreaticoduodenectomy (PD), and to provide the management strategies for this complication.

METHODSThe clinic data of 412 patients who underwent PD from January 2000 to April 2010 was retrospectively reviewed. There were 232 male and 180 female patients, average age was (60 ± 12) years. The mode of procedure was standard PD and the Child's reconstruction of digestive tract, whose anastomosic steps encluded gastroenterostomy following chlangioenterostomy and pancreaticoenterostomy, was employed. Etiology of gastrointestinal haemorrhage, diagnostic methods and treatment strategy was recorded and analyzed.

RESULTSThe postoperative mobidity was 37.1% (153/412), the rate of haemorrhagic complications was 6.6% (27/412), and gastrointestinal hemorrhage was recorded in 11 patients (2.7%). The bleeding rate of pancreaticointestinal anastomosis and gastricointestinal anastomosis were 5/11 and 4/11, respectively. Among these 11 patients, early hemorrhage occurred in 6 patients, 7 patients were due to technical failure. In order to control this kind of complication, open abdominal operation alone was performed on 4 patients, endoscopic management was performed on 3 patients and succeeded in 2 patients, vascular interventional therapy was performed on 5 patients and succeeded in 2 patients, and Re-laparotomy following vascular interventional therapy was performed on 2 patients successfully.

CONCLUSIONSGastrointestinal hemorrhage following PD always occurred in early stage and reliable hemostasis during operation is the key points for prevention. Angiography is minimally invasive and holds the diagnostic value. Timely and decisive reoperation is an important method to management of postoperative gastrointestinal hemorrhage.

Aged ; Female ; Gastrointestinal Hemorrhage ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Pancreaticoduodenectomy ; adverse effects ; Postoperative Hemorrhage ; therapy ; Retrospective Studies ; Treatment Outcome

Most patients with strabismus are in good health. However, the incidence of strabismus is high in patients with central nervous system dysfunction and musculoskeletal abnormalities. Authors report one case of intracerebral hematoma due to bleeding from an intracranial arteriovenous malformation after a surgical correction of strabismus under general endotracheal anesthesia. The initial operation and postoperative course of this case were uneventful except for several episodes of nausea and vomiting, continuing hours after the operation. Twenty-four hours after the operation, the patient showed a stuporous mental state and right-sided hemiplegia. A brain C-T scan and carotid angiography revealed an intracerebral hematoma with small-sized vascular abnormalities in the frontoparietal region on the left side. Following an emergency evacuation of the hematoma and removal of the malformed vessels, the patient showed progressive improvement.
Cerebral Hemorrhage/etiology* ; Child ; Female ; Hematoma/etiology* ; Human ; Intracranial Arteriovenous Malformations/complications ; Postoperative Complications* ; Rupture, Spontaneous ; Strabismus/surgery*