title: Management of difficult intra operative bleeding by abdominal packing: report of four cases.
abstract: Difficult perioperative bleeding in four obstetric and gynaecology patients was managed with temporising abdominal packs left in place with abdominal closure for 48-72 hours in order to avoid deaths on the operating table when blood loss could not be adequately replaced and hemostasis could not be secured. Abdominal re-opening to remove the packs was undertaken. Three of the patients were eventually discharged home after satisfactory recovery. The fourth died of sepsis three weeks after the fourth re-operation and bilateral internal iliac artery ligation. Abdominal packing thus has a place in the management and salvage of patients with difficult obstetric and gynaecologic perioperative bleeding.
authors.affiliation: Department of Obstetrics and Gynaecology, Ghana Medical School, Accra, Ghana.
authors.forename: A T
authors.initials: AT
authors.lastname: Lassey
authors.forename: T S
authors.initials: TS
authors.lastname: Ghosh
authors.forename: J B
authors.initials: JB
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D006470:Hemorrhage / Q000628:therapy*; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy*; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy