Patterns of Post-thyroidectomy Hemorrhage.
OBJECTIVE
Postoperative hemorrhage is a potentially life-threatening complication in thyroid surgery. This study was performed to review the clinical patterns of post-thyroidectomy hemorrhage, and especially as they are related to the source of bleeding.


METHODS
We performed a retrospective review of 10 patients (0.96%) with post-thyroidectomy hemorrhage that required surgical evacuation. The clinical patterns such as the time interval from surgery to hemorrhage and the signs and symptoms according to the bleeding focus were evaluated.


RESULTS
The mean time interval from surgery to symptom onset was 7 hr 52 min. Six cases showed bleeding deep to the strap muscles, while the other 4 cases showed bleeding superficial to the muscles. Ecchymosis was prominent and dark in color in 3 of the 4 cases (75%) of superficial bleeding, however it was identified in only 2 of the 6 cases (33%) of deep bleeding. Respiratory distress occurred in two cases of hematoma deep to the strap muscles, but in none of the cases with superficial bleeding.


CONCLUSIONS
The post-thyroidectomy hemorrhage had some different clinical patterns between the superficial cases and the deep cases, showing that life-threatening airway obstruction occurred from the deep hematoma. A thorough understanding of the clinical patterns of post-thyroidectomy hemorrhage between the cases of superficial and those cases of deep hematoma may provide valuable surgical tips to manage this potentially lethal complication.
Lee
Hyoung Shin
HS
Department of Otolaryngology-Head and Neck Surgery, Nam-hae Hospital, Namhae, Korea.
Lee
Bong Ju
BJ
Kim
Sung Won
SW
Cha
Young Woo
YW
Choi
Young Sik
YS
Park
Yo Han
YH
Lee
Kang Dae
KD