Evaluation and Management of Patients with Hematoma After Gynecologic and Obstetric Surgery

Objective: Postoperative hematoma following abdominal surgery is relatively rare and mainly depends on the type of surgery. Specific treatment including surgery or interventional radiology is sometimes necessary. The aim of this study is to evaluate the cases of postoperative hematoma after gynecol...

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Main Authors: Bekir Kahveci, Mehmet Obut, Serhat Ege, Mete Sucu, Nurullah Peker, Osman Uzundere, Gaye Kahveci, Mehmet Sukru Budak
Format: Article
Language:English
Published: Medical Network 2021-04-01
Series:Gynecology Obstetrics & Reproductive Medicine
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Online Access:https://gorm.com.tr/index.php/GORM/article/view/961
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author Bekir Kahveci
Mehmet Obut
Serhat Ege
Mete Sucu
Nurullah Peker
Osman Uzundere
Gaye Kahveci
Mehmet Sukru Budak
author_facet Bekir Kahveci
Mehmet Obut
Serhat Ege
Mete Sucu
Nurullah Peker
Osman Uzundere
Gaye Kahveci
Mehmet Sukru Budak
author_sort Bekir Kahveci
collection DOAJ
description Objective: Postoperative hematoma following abdominal surgery is relatively rare and mainly depends on the type of surgery. Specific treatment including surgery or interventional radiology is sometimes necessary. The aim of this study is to evaluate the cases of postoperative hematoma after gynecologic and obstetric surgery. Study Design: This is a retrospective cohort study of 30 patients with hematoma developed after gynecologic and obstetric surgery. We included the patients who hospitalized with the diagnosis of a postoperative hematoma between June 2017 and April 2019 at Gazi Yasargil Training and Research Hospital of Health Sciences University. Hematomas occurring after endoscopic surgery and episiotomy were not included. The diagnosed cases were divided into three groups as wound hematoma, rectus sheath hematoma and intra-abdominal hematoma (intraperitoneal and retroperitoneal). All cases were assessed by patient demographics and clinical findings, hematoma of characteristics, treatment methods and results. Results: A total of 30 patients were included in the study with a mean age of 33.0±8.6 years. Incidence of hematoma account for 0.2%. The mean c-reactive protein was 37.9±47.4 mg/dL at admission and 14.6±25.8 mg/dL at discharge, respectively. The decrease was statistically significant (p < 0.001). The mean hemoglobin was 10.6±2.1 g/dL at admission and 10.7±1.5 g/dL at discharge. Fever was detected in 7 (23.3%) patients. Only 12 patients (40%) were followed up by observation and symptom management. In 10 (33.3%) patients, antibiotics were included in the treatment due to infection. In addition, 4 patients (13.3%) had relaparotomy, 5 patients (16.7%) underwent percutaneous radiological drainage and 8 (26.7%) received blood transfusion. The mean time of resorption of the hematoma was 4.6 ± 2.0 days. The evaluation of the hematoma locations revealed that 14 patients (46.7%) had wound hematoma, 7 patients (23.3%) had rectus sheath hematoma (Type I: 2 cases, type II: 3 cases, type III: 2 cases), 8 patients (26.7%) had pelvic hematoma and 2 patients (6.7%) had a retroperitoneal hematoma. The mean hematoma size was 68.1±15.18 mm. Conclusions: In cases of hematoma resistant to antibiotic treatment and non-resorbable hematoma, we can consider percutaneous catheter drainage as an alternative to surgical intervention.
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series Gynecology Obstetrics & Reproductive Medicine
spelling doaj-art-ccc609d99f774be5910730d76f01ce5c2025-02-11T21:11:51ZengMedical NetworkGynecology Obstetrics & Reproductive Medicine1300-47512602-49182021-04-0127110.21613/GORM.2019.961Evaluation and Management of Patients with Hematoma After Gynecologic and Obstetric SurgeryBekir Kahveci0Mehmet Obut1Serhat Ege2Mete Sucu3Nurullah Peker4Osman Uzundere5Gaye Kahveci6Mehmet Sukru Budak7Health Sciences University, Gazi Yasargil Research and Training Hospital, DiyarbakırHealth Sciences University, Gazi Yasargil Research and Training Hospital, DiyarbakırHealth Sciences University, Gazi Yasargil Research and Training Hospital, DiyarbakırCukurova University, AdanaDicle University, DiyarbakirHealth Sciences University, Gazi Yasargil Research and Training Hospital, DiyarbakırDicle University, DiyarbakırHealth Sciences University, Gazi Yasargil Research and Training Hospital, Diyarbakır Objective: Postoperative hematoma following abdominal surgery is relatively rare and mainly depends on the type of surgery. Specific treatment including surgery or interventional radiology is sometimes necessary. The aim of this study is to evaluate the cases of postoperative hematoma after gynecologic and obstetric surgery. Study Design: This is a retrospective cohort study of 30 patients with hematoma developed after gynecologic and obstetric surgery. We included the patients who hospitalized with the diagnosis of a postoperative hematoma between June 2017 and April 2019 at Gazi Yasargil Training and Research Hospital of Health Sciences University. Hematomas occurring after endoscopic surgery and episiotomy were not included. The diagnosed cases were divided into three groups as wound hematoma, rectus sheath hematoma and intra-abdominal hematoma (intraperitoneal and retroperitoneal). All cases were assessed by patient demographics and clinical findings, hematoma of characteristics, treatment methods and results. Results: A total of 30 patients were included in the study with a mean age of 33.0±8.6 years. Incidence of hematoma account for 0.2%. The mean c-reactive protein was 37.9±47.4 mg/dL at admission and 14.6±25.8 mg/dL at discharge, respectively. The decrease was statistically significant (p < 0.001). The mean hemoglobin was 10.6±2.1 g/dL at admission and 10.7±1.5 g/dL at discharge. Fever was detected in 7 (23.3%) patients. Only 12 patients (40%) were followed up by observation and symptom management. In 10 (33.3%) patients, antibiotics were included in the treatment due to infection. In addition, 4 patients (13.3%) had relaparotomy, 5 patients (16.7%) underwent percutaneous radiological drainage and 8 (26.7%) received blood transfusion. The mean time of resorption of the hematoma was 4.6 ± 2.0 days. The evaluation of the hematoma locations revealed that 14 patients (46.7%) had wound hematoma, 7 patients (23.3%) had rectus sheath hematoma (Type I: 2 cases, type II: 3 cases, type III: 2 cases), 8 patients (26.7%) had pelvic hematoma and 2 patients (6.7%) had a retroperitoneal hematoma. The mean hematoma size was 68.1±15.18 mm. Conclusions: In cases of hematoma resistant to antibiotic treatment and non-resorbable hematoma, we can consider percutaneous catheter drainage as an alternative to surgical intervention. https://gorm.com.tr/index.php/GORM/article/view/961Gynecologic and obstetric surgeryPercutaneous catheterPostoperative hematoma drainage.
spellingShingle Bekir Kahveci
Mehmet Obut
Serhat Ege
Mete Sucu
Nurullah Peker
Osman Uzundere
Gaye Kahveci
Mehmet Sukru Budak
Evaluation and Management of Patients with Hematoma After Gynecologic and Obstetric Surgery
Gynecology Obstetrics & Reproductive Medicine
Gynecologic and obstetric surgery
Percutaneous catheter
Postoperative hematoma drainage.
title Evaluation and Management of Patients with Hematoma After Gynecologic and Obstetric Surgery
title_full Evaluation and Management of Patients with Hematoma After Gynecologic and Obstetric Surgery
title_fullStr Evaluation and Management of Patients with Hematoma After Gynecologic and Obstetric Surgery
title_full_unstemmed Evaluation and Management of Patients with Hematoma After Gynecologic and Obstetric Surgery
title_short Evaluation and Management of Patients with Hematoma After Gynecologic and Obstetric Surgery
title_sort evaluation and management of patients with hematoma after gynecologic and obstetric surgery
topic Gynecologic and obstetric surgery
Percutaneous catheter
Postoperative hematoma drainage.
url https://gorm.com.tr/index.php/GORM/article/view/961
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