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Re: Post OP bleeding thoughts?From: Andrew Folley (agfolley@hotmail.com)Wed Jun 20 12:40:06 2007
Did a TAH LSO pfannemstiel on healthy 45 yo WF 120 pounds monday for large ovarian neoplasm (serous cystadenoma) Easy straight forward ebl 250 cc etc. 4 hours later called by recovery that she is bleeding fairly heavy from vagina "soaking pads" etc. Bp low 90/40 poor urine output 120cc in 4 hrs. Hb 11.3 preop 13. Take her to OR as the vaginal bleeding was immpressive. In or hb 8.3 and she gets transused with 2 units. Approach through the vagina. everything oozing nothing obvious pumping. Retie the uterine pedicles and whip stitch the cuff and pack vagina. She does fine. Initial clotting studies in recovery before transfusion show elevated PT PTT and INR and low fibrinogen suggesting to me at least DIC. I am just surprised she developed DIC so quickly or is there an underlying coagulation problem?? Thoughts for tests?
>From: Len2976@aol.com
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