Tamminen Anselm
Department of Plastic and General Surgery, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland.
Department of Surgery, Faculty of Medicine, University of Turku, Kiinamyllynkatu 10, 20520 Turku, Finland.
JPRAS Open. 2025 Apr 3;44:375-378. doi: 10.1016/j.jpra.2025.03.024. eCollection 2025 Jun.
Postoperative bleeding after mastectomy is rarely a life-threatening complication. However, it can be fatal without treatment, particularly in patients taking antithrombotic medications. We present a case of 84-year-old woman with atrial fibrillation and apixaban medication, who developed breast cancer requiring mastectomy. The patient experienced severe post-operative bleeding on the fifth postoperative day, with first symptoms being disorientation, stomachache, and unstable hemodynamics. A contrast-enhanced computed tomography revealed an active bleeding site superficially in the skin flap. Unfortunately, the patient had to face a two-hour delay before emergency surgery could be performed and the on-call surgeon decided to attempt an unconventional treatment. The source of the bleeding was pinpointed using Doppler ultrasound in the emergency room, and the artery was occluded with a large needle and a figure-of-eight suture.
乳房切除术后出血很少是危及生命的并发症。然而，如果不治疗，它可能是致命的，尤其是在服用抗血栓药物的患者中。我们报告一例84岁患有心房颤动且正在服用阿哌沙班的女性患者，她罹患乳腺癌需要进行乳房切除术。该患者在术后第五天出现严重的术后出血，最初症状为定向障碍、腹痛和血流动力学不稳定。增强计算机断层扫描显示皮瓣表面有一个活动性出血部位。不幸的是，患者在急诊手术前不得不面临两小时的延迟，值班外科医生决定尝试一种非常规治疗。在急诊室使用多普勒超声确定了出血源，并用大针和8字缝合法阻塞了动脉。
