Late retroperitoneal hematoma with abscess formation following laparoscopic staging of endometrial cancer

Casanova, João; Sicam, Renee Vina G.; Moreira-Barros, Joana; Huang, Kuan-Gen

doi:10.4103/gmit.gmit_3_17

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…As for the differential diagnosis of hematoma from the abscess, we reviewed the English literature in MEDLINE for reports on retroperitoneal hematoma with infection and found several case reports [ 24 – 26 ]. In all these cases, the patients presented with fever or severe inflammatory findings in the laboratory.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous retroperitoneal hematoma with duodenal obstruction with diagnostic use of endoscopic ultrasound: A case series and literature review

Makazu

Koizumi

Masuda

et al. 2023

Clin J Gastroenterol

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Spontaneous retroperitoneal hematoma is rare and can cause duodenal obstruction. We report four cases of spontaneous retroperitoneal hematoma with duodenal obstruction, wherein endoscopic ultrasound was useful for diagnosis. The patients complained of vomiting with stable vital signs. Computed tomography, esophagogastroduodenoscopy, and endoscopic ultrasound findings were similar in all cases. Contrast-enhanced computed tomography revealed a low-density mass around the 2nd to 3rd part of the duodenum. Esophagogastroduodenoscopy showed an edematous, reddish, but non-neoplastic duodenal mucosa with stenosis of the lumen. Endoscopic ultrasound revealed a low-echoic mass around the duodenum and high-echoic floating matter suggesting debris and anechoic areas that indicated a liquid component. These findings suggested hematomas or abscesses. Although pseudoaneurysm of the pancreaticoduodenal artery was suspected in Case 3, we chose conservative treatment because the aneurysm was small. In Case 4, median arcuate ligament syndrome was suspected on angiography. No aneurysms or arteriovenous malformations were found; thus, endovascular embolization was not performed. The patients were treated conservatively and discharged within 3–5 weeks. English literature queries on spontaneous retroperitoneal hematoma with duodenal obstruction in MEDLINE revealed 21 cases in 18 studies. The clinical features of these patients and the present four cases have been discussed.

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Section: Discussionmentioning

confidence: 99%

Spontaneous retroperitoneal hematoma with duodenal obstruction with diagnostic use of endoscopic ultrasound: A case series and literature review

Makazu

Koizumi

Masuda

et al. 2023

Clin J Gastroenterol

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“…There is only one previous case report by Lev-Gur et al that describes a vaginal hysterectomy that resulted in a pararenal hematoma; however, this study was not able to demonstrate the hematoma expanding beyond the vaginal cuff due to limitation by ultrasonography, and their lack of utilization of CT [ 9 ]. Other cases of RP hematomas secondary to gynecologic procedures include abscess formation following the laparoscopic staging of endometrial cancer [ 10 ], and pudendal block for vaginal delivery [ 11 ], both of which required non-invasive treatment with antibiotics. Zorrilla et al reported a case of spontaneous rupture of an ovarian artery pseudoaneurysm that required embolization of the right ovarian artery [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Large Retroperitoneal Hematoma: A Rare Intraoperative Complication of Total Vaginal Hysterectomy

Fuchs¹,

Parthasarathy²,

Coots³

et al. 2021

Cureus

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Retroperitoneal (RP) hematoma is a rare complication of total vaginal hysterectomy. A 45-year-old female G4P3013 with a history of abnormal uterine bleeding refractory to treatment by endometrial ablation and stress urinary incontinence underwent total vaginal hysterectomy, bilateral salpingectomy, bilateral uterosacral ligament suspension, anterior colporrhaphy, and cystoscopy. After the hysterectomy the left uterine artery pedicle was hemostatic; however, the patient became hemodynamically unstable and anemic. Laparoscopy revealed a stable zone III RP hematoma. Intraoperative observation revealed no further expansion of the hematoma. Left iliac angiography and aortography revealed there was no extravasation from the uterine arteries and gonadal vessels. Four days post-operative abdominal CT showed a stable hematoma. Hemodynamic instability resolved over the post-operative course. RP hematoma must be included in the differential for the evaluation of acute intraoperative hemodynamic instability with an unclear source.

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“…4,5 In addition, the residual hematoma is an excellent nidus for bacterial infection. 6 This excess fluid can lead to patients requiring urgent surgical drainage or becoming infected, or it can exacerbate eventual chronic inflammatory complications such as capsular contracture. 7 Although surgeons consistently strive for meticulous intraoperative hemostasis and place drains to minimize the fluid collection, the reported rates of seroma and hematoma following mastectomy with direct-to-implant (DTI) reconstruction remain at 6.7% and 3.4%, respectively.…”

mentioning

confidence: 99%

Topical Tranexamic Acid in Breast Reconstruction: A Double-Blind, Randomized Controlled Trial

Safran

Vorstenbosch

Viezel-Mathieu

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Breast cancer affects one in every eight women, many of whom will undergo treatment with mastectomy and implant-based breast reconstruction. 1 Breast cancer reconstruction has been shown to improve patientreported outcomes in physical, psychosocial, and sexual well-being domains. 2 Even with advances in prosthetic devices, reconstructive techniques, and mastectomy flap quality, recent reviews have demonstrated that surgical complications can arise in up to 20% of alloplastic breast Background: Excess fluid accumulation (seroma/hematoma) around the breast implant after reconstruction can lead to significant complications. Topical administration of tranexamic acid (TXA) may reduce fluid accumulation and reduce postoperative complications. This trial aims to investigate whether TXA-treated mastectomy pockets will exhibit less postoperative fluid production and complications. Methods: This paired, double-blind, randomized, controlled trial enrolled patients undergoing bilateral mastectomies with immediate direct-to-implant reconstruction. In each patient, one breast was randomized to receive 3 g of TXA (100 cc), and the other received 100 cc of normal saline. The blinded solutions were soaked in the mastectomy pocket for 5 minutes before implant placement. Postoperatively, daily drain outputs, complications, and baseline demographics were recorded. Results: Fifty-three eligible patients, representing 106 breasts, were enrolled. All patients underwent bilateral nipple-sparing mastectomies. After randomization, TXA was placed in the right breast in 30 patients (56.6%). The use of topical TXA resulted in a mean drain output reduction of 30.5% (range, −83.6% to 26.6%). Drains on the TXA-treated breast were eligible for removal 1.4 days (range, 0 to 4 days) sooner than the control side. The TXA-treated group had three complications (5.67%) versus 15 (28.3%) in the control group (OR, 0.1920; P = 0.0129). Specifically, for operative hematomas, the TXA group had none (0%), versus three in the control group (5.7%) (OR, 0.1348; P = 0.18). Conclusions: Soaking the mastectomy bed with 3% topical TXA before implant insertion leads to a decrease in drain output and a decrease in complications. Topical administration of TXA represents an option to decrease complications in alloplastic breast reconstruction.

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Late retroperitoneal hematoma with abscess formation following laparoscopic staging of endometrial cancer

Cited by 4 publications

References 7 publications

Spontaneous retroperitoneal hematoma with duodenal obstruction with diagnostic use of endoscopic ultrasound: A case series and literature review

Spontaneous retroperitoneal hematoma with duodenal obstruction with diagnostic use of endoscopic ultrasound: A case series and literature review

Large Retroperitoneal Hematoma: A Rare Intraoperative Complication of Total Vaginal Hysterectomy

Topical Tranexamic Acid in Breast Reconstruction: A Double-Blind, Randomized Controlled Trial

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