title: Secondary haemorrhage after dacryocystorhinostomy.
abstract: OBJECTIVE
  To describe the incidence, clinical features, possible risk factors and outcome of patients suffering secondary haemorrhage after dacryocystorhinostomy (DCR).
  
  
  METHODS
  Records of all patients undergoing external DCR by one surgeon (AAM) over a 6-year period were analysed retrospectively.
  
  
  RESULTS
  After 293 DCR operations in 260 patients, 10 patients had a secondary haemorrhage (one after bilateral DCR), usually between days 4 and 10 post-operatively (mean 6.8 days). Six of the 10 were hospitalized for 2-5 days (mean 2.8 days), all of whom had nasal packing, intravenous antibiotics and intravenous fluids; none required blood transfusion. Three patients had immune system defects, three had used non-steroidal anti-inflammatory drugs (NSAID) and four had no obvious risk factors. All 10 had a successful outcome following DCR (compared to an overall failure rate of 25/293 (8.5%): 16 anatomical and nine functional).
  
  
  CONCLUSIONS
  Secondary haemorrhage after DCR was found to occur after 3.8% of DCR. Risk factors include being immunocompromised and taking NSAID prior to surgery. The haemorrhage did not adversely affect surgical outcome.
authors.affiliation: Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Tsirbas
authors.forename: A A
authors.initials: AA
authors.lastname: McNab
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003608:Dacryocystorhinostomy / Q000009:adverse effects*; D005130:Eye Hemorrhage / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal