Conservative Treatment of a Huge Abdominal Wall Hematoma After Laparoscopic Appendectomy

Fernández, Eudaldo M. López-Tomassetti; Malagón, Antonio Martín; Arteaga, Iván; Díaz, Hermógenes; Carrillo, Ángel

doi:10.1089/lap.2005.15.634

Cited by 17 publications

(6 citation statements)

References 16 publications

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“…Several methods of treatment exist such as conservative management, suturing-(for instance with a Reverdin or Stamey needle and laparoscopic port fascial closure suture passer), electrocautery and Foley catheter tamponade. [8][9][10] However, an enlargement of the incision and placement of sutures is still widely considered the classical method. 11 However, the Foley catheter is a cheap and readily available effective tool to control abdominal wall bleeding with multiple advantages, they are: It allows the haemorrhage to be controlled by creating counter pressure, against which the vessel can be compressed, the placement of a Foley catheter is time-efficient procedure as compared to suturing and any other known technique, a study reports that the placement of a Foley catheter may be associated with lower postoperative pain.…”

Section: Discussionmentioning

confidence: 99%

Foley catheter tamponade-an effective and first line management of epigastric port site bleed in laparoscopic cholecystectomy: a study of 23 cases over 20 years

Ray

Panchal²,

Thakore³

et al. 2022

Int Surg J

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Background: To study a simple yet effective surgical technique of management of epigastric port site bleed and how to prevent such an incidental surgical accident in patients undergoing laparoscopic cholecystectomy.Methods: This is a prospective pilot study done during last 20 years in patients undergoing laparoscopic cholecystectomy, who accidentally developed epigastric port-side bleed. A 22 Fr inflated Foley catheter under traction was used to control the bleeding. After an average 24-48 hours of traction tamponade, the catheter was deflated and removed accordingly.Results: The 23 patients had a complication of epigastric port bleeding, in which Foley’s catheter tamponade was used. In 22 (99.65%) cases, bleeding was controlled effectively with Foley catheter tamponade. Only in 01 patient bleeding could not be controlled with the usually applied traction, so an enhanced traction was introduced, with our indigenously fabricated external contraption. No case required wound exploration or any other sophisticated means of controlling epigastric port site bleed. There was no mortality.Conclusions: One of the most common complications of laparoscopic surgery is epigastric port site bleeding, which is an avoidable complication, provided proper procedure is followed in establishing this port.

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Section: Discussionmentioning

confidence: 99%

Foley catheter tamponade-an effective and first line management of epigastric port site bleed in laparoscopic cholecystectomy: a study of 23 cases over 20 years

Ray

Panchal²,

Thakore³

et al. 2022

Int Surg J

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“…In these circumstances epigastric vessels are those most commonly injured [9]. Deep and superficial epigastric vessels arise from the external iliac and femoral artery, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Use of hand-held Doppler ultrasound for abdominal wall vascular localization is also described [11]. Entering the port at a right angle to the abdominal wall and use of the smallest trocars possible may decrease the possibility of this complication [9]. …”

Section: Discussionmentioning

confidence: 99%

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Intra-abdominal and abdominal wall haematoma from 5 mm port insertion site in laparoscopic cholecystectomy.

Mohammadhosseini¹,

Shirani²

2011

Videosurgery and Other Miniinvasive Techniques

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Trocar insertion is an essential and initial part in any laparoscopic procedure. Inadvertent abdominal wall vascular injury, leading to intra-abdominal bleeding or abdominal wall haematoma due to trocar insertion, may occur at this first step. We report here a case of uneventful laparoscopic cholecystectomy in a 44-year-old woman, which was followed later by large abdominal wall haematoma through the 5 mm trocar insertion site. Emergency laparotomy was needed to control the bleeding. Delayed abdominal wall haematoma can occur even with most lateral, 5 mm trocar insertions. Learning abdominal wall vascular anatomy, transilluminating the abdominal wall before trocar insertion and entering the abdominal cavity at a right angle may decrease the possibility of this complication.

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“…Trauma to abdominal wall blood vessels has been reported in up to 3.4% of laparoscopic procedures. [4] Most commonly injured vessels in laparoscopic procedures are the epigastric vessels. The epigastric vessels are usually located in the area between 4 and 8 cm from the midline.…”

Section: Discussionmentioning

confidence: 99%

Rectus sheath abscess after laparoscopic appendicectomy

Golash

2007

J Min Access Surg

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Port site wound infection, abdominal wall hematoma and intraabdominal abscess formation has been reported after laparoscopic appendicectomy. We describe here a rectus sheath abscess which occurred three weeks after the laparoscopic appendicectomy. It was most likely the result of secondary infection of the rectus sheath hematoma due to bleeding into the rectus sheath from damage to the inferior epigastric arteries or a direct tear of the rectus muscle. As far as we are aware this complication has not been reported after laparoscopic appendicectomy.

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Conservative Treatment of a Huge Abdominal Wall Hematoma After Laparoscopic Appendectomy

Cited by 17 publications

References 16 publications

Foley catheter tamponade-an effective and first line management of epigastric port site bleed in laparoscopic cholecystectomy: a study of 23 cases over 20 years

Foley catheter tamponade-an effective and first line management of epigastric port site bleed in laparoscopic cholecystectomy: a study of 23 cases over 20 years

Intra-abdominal and abdominal wall haematoma from 5 mm port insertion site in laparoscopic cholecystectomy.

Rectus sheath abscess after laparoscopic appendicectomy

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