Alfahad Aws, Ibrahim Dura, Ibrahim Basil, Alfahad Rami
Radiology, American Hospital Dubai, Dubai, ARE.
Surgery, Manchester Foundation Trust, Manchester, GBR.
Cureus. 2025 Oct 18;17(10):e94879. doi: 10.7759/cureus.94879. eCollection 2025 Oct.
Post-procedural hematomas are uncommon but clinically significant complications that can lead to morbidity and mortality. Conventional management often requires surgical re-exploration or embolization, which may be technically unfeasible or high risk in patients with multiple comorbidities. Thrombin injection, although well established for pseudoaneurysm treatment, has been less frequently reported in the management of postsurgical hematomas. We describe five patients who developed post-procedural hematomas following different interventions: robotic hernia repair, ovarian cystectomy, percutaneous nephrostomy, endoscopy, and percutaneous endoscopic gastrostomy tube insertion. Each patient was treated with image-guided thrombin injection under computed tomography or ultrasound guidance. Hemostasis was successfully achieved in all cases without thrombin-related complications, and patients recovered without the need for surgical or major endovascular intervention. Image-guided thrombin injection is a safe, effective, and minimally invasive technique for managing selected post-procedural hematomas. This case series highlights its potential as an alternative when conventional surgical or embolization options are not feasible. Further studies are needed to standardize protocols and evaluate long-term outcomes.
术后血肿虽不常见，但却是具有临床意义的并发症，可导致发病和死亡。传统治疗通常需要再次手术探查或栓塞，对于患有多种合并症的患者，这在技术上可能不可行或风险很高。凝血酶注射虽然在假性动脉瘤治疗中已得到充分确立，但在术后血肿的管理中报道较少。我们描述了5例在不同干预措施后发生术后血肿的患者：机器人疝气修补术、卵巢囊肿切除术、经皮肾造瘘术、内镜检查和经皮内镜下胃造口管插入术。每位患者均在计算机断层扫描或超声引导下接受了图像引导下的凝血酶注射治疗。所有病例均成功实现止血，且无凝血酶相关并发症，患者无需手术或重大血管内介入即可康复。图像引导下的凝血酶注射是一种安全、有效且微创的技术，用于处理特定的术后血肿。本病例系列突出了其在传统手术或栓塞选择不可行时作为替代方法的潜力。需要进一步研究以规范方案并评估长期结果。
