Delayed, massive bleeding as an unusual complication of laser conization. A case report.
BACKGROUND
Although delayed bleeding following cervical conization is a common complication of this surgical procedure, the amount of blood loss is usually not life threatening.


METHODS
A 27-year-old woman underwent conization with a KTP laser for the treatment of microinvasive cervical adenocarcinoma. Eight days later the patient experienced sudden, massive genital bleeding at her workplace. The source of the bleeding was identified as a descending branch of the left uterine artery exposed to the wound surface. Hemostasis was achieved completely with direct surgical ligature of the exposed blood vessel. The patient's blood loss during the course of the events was estimated to be 3.2 L, for which she received 1.4 L of packed red blood cells. She had an uneventful postoperative recovery. There was no bleeding or recurrence of the disease during 4 years of follow-up.


CONCLUSIONS
Clinicians should be alert to the possibility of massive bleeding as a delayed surgical complication of cervical conization.
Kurata
Hitoshi
H
Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Science, Asahimachi-dori 1-757, Niigata, 951-8510, Japan. tounin@med.niigata-u.ac.jp
Aoki
Yoichi
Y
Tanaka
Kenichi
K
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D001810:Blood Volume; D019092:Conization / Q000009:adverse effects*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000209:etiology*; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000601:surgery*