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What Could The Reason For The Large Of Fluid Draining Which Still Seems To Contain A Large Amount Of Bleeding?
Question: Hi,
A family member of mine underwent a mastectomy a week ago. This was after a more minor procedure to remove just the affected area/lump about a month before the mastectomy.
There is still a lot of fluid and blood draining per day a week after the procedure. Roughly 300-400 ml per day. There is also some swelling in the area.
What could the reason for the large of fluid draining which still seems to contain a large amount of bleeding? Could the previous surgical procedure have contributed to the amount of fluids draining?
Are there any steps possible to relieve symptoms? Could taking electrolyte fluids such as Hydralyte be helpful or taking iron pills? Blood pressure is slightly low at around 110/60.
The surgeon is away. Would it be recommended to visit possibly a breast care clinic in the meantime to follow up?
Thank you,
Regards
A family member of mine underwent a mastectomy a week ago. This was after a more minor procedure to remove just the affected area/lump about a month before the mastectomy.
There is still a lot of fluid and blood draining per day a week after the procedure. Roughly 300-400 ml per day. There is also some swelling in the area.
What could the reason for the large of fluid draining which still seems to contain a large amount of bleeding? Could the previous surgical procedure have contributed to the amount of fluids draining?
Are there any steps possible to relieve symptoms? Could taking electrolyte fluids such as Hydralyte be helpful or taking iron pills? Blood pressure is slightly low at around 110/60.
The surgeon is away. Would it be recommended to visit possibly a breast care clinic in the meantime to follow up?
Thank you,
Regards
Brief Answer:
To find the cause to have specific management is the key.
Detailed Answer:
Hi.
Thanks for your query.
Noted the history and understood the concerns.
Previous surgery may not be the reason for the present day symptoms.
The commonest reasons I can think about for the bleeding and fluid discharge are as follows.
- Since the patient is on anti-hypertensive medications it is possible that the patient is on blood thinners. So to find out if the patient is on any blood thinner medicines or some medicines like NSAIDS or others that can cause persistent bleeding.
- Bleeding, clotting disorders to be ruled out. Bleeding time, clotting time, prothrombine times, platelet count and other advanced investigations to rule out any disorders interfering with the clotting mechanism should be done. If found to be treated accordingly. Second opinion of a Hematologist may be needed and be helpful if any investigations suggest so.
- Local internal infection can cause such symptoms. It may be possible to get Ultrasound, color doppler and any such investigations as would be advised by your Doctors or in ER .
- Small bleeding vessels- very rare after 7 days of any procedure. But a Surgeon can ascertain well.
- Liver and kidney disease can cause such symptoms.
Hence a the patient should be seen by a Doctor/ at ER/ or so as soon as possible, thorough clinical examination, investigations will help to know the cause and thus a specific management can help.
- Blood transfusion if needed.
- Vit K and calcium may help. But let Doctors decide.
- If blood pressure is falling may need adjustment of the blood pressure medications.
- Hydralyte will help to maintain hydration.
- Nothing specific can be done at home hence your idea of visiting a specialist place should be done as soon as possible.
I hope this answers your queries and helps patient.
Please give follow up and ask for any further relevant queries if you feel that there is a gap of communication.
Dr T Chandrakant.
General Surgeon.
To find the cause to have specific management is the key.
Detailed Answer:
Hi.
Thanks for your query.
Noted the history and understood the concerns.
Previous surgery may not be the reason for the present day symptoms.
The commonest reasons I can think about for the bleeding and fluid discharge are as follows.
- Since the patient is on anti-hypertensive medications it is possible that the patient is on blood thinners. So to find out if the patient is on any blood thinner medicines or some medicines like NSAIDS or others that can cause persistent bleeding.
- Bleeding, clotting disorders to be ruled out. Bleeding time, clotting time, prothrombine times, platelet count and other advanced investigations to rule out any disorders interfering with the clotting mechanism should be done. If found to be treated accordingly. Second opinion of a Hematologist may be needed and be helpful if any investigations suggest so.
- Local internal infection can cause such symptoms. It may be possible to get Ultrasound, color doppler and any such investigations as would be advised by your Doctors or in ER .
- Small bleeding vessels- very rare after 7 days of any procedure. But a Surgeon can ascertain well.
- Liver and kidney disease can cause such symptoms.
Hence a the patient should be seen by a Doctor/ at ER/ or so as soon as possible, thorough clinical examination, investigations will help to know the cause and thus a specific management can help.
- Blood transfusion if needed.
- Vit K and calcium may help. But let Doctors decide.
- If blood pressure is falling may need adjustment of the blood pressure medications.
- Hydralyte will help to maintain hydration.
- Nothing specific can be done at home hence your idea of visiting a specialist place should be done as soon as possible.
I hope this answers your queries and helps patient.
Please give follow up and ask for any further relevant queries if you feel that there is a gap of communication.
Dr T Chandrakant.
General Surgeon.
Above answer was peer-reviewed by :
Dr. Kampana
Dear Dr. Chandrakant,
Thank you for your detailed opinion and assessment.
I have found that the patient is not on any blood thinners or NSAIDs. I advised that a visit to a doctor or hospital emergency department should be arranged now.
I am just wondering could there have been a surgical error or is most likely due to a patient's individual factors? Does this procedure involve a need to stitch back any particular veins or vessels? I am unsure what procedure was used, whether manual, electrocautery or ultrasonic.
Thank you,
Regards.
Thank you for your detailed opinion and assessment.
I have found that the patient is not on any blood thinners or NSAIDs. I advised that a visit to a doctor or hospital emergency department should be arranged now.
I am just wondering could there have been a surgical error or is most likely due to a patient's individual factors? Does this procedure involve a need to stitch back any particular veins or vessels? I am unsure what procedure was used, whether manual, electrocautery or ultrasonic.
Thank you,
Regards.
Brief Answer:
As detailed
Detailed Answer:
Thanks for your feedback.
Indeed, patient should be taken to the medical/surgical facility for clinical examination, investigations and proper management. It is good that the patient is not on blood thinner or NSAIDs. I also hope that the patient is not taking and herbal products or supplements.
Arterial bleeding is too much and needs immediate attention.
It may be venous or just oozing due to large open space at operative site, opposite surfaces not yet attached to each other. Hence the healing area being very large can ooze more blood tinged fluid. May need vacuum drainage. Of course as decided by the Surgeon.
I hope this answer helps you further.
With Regards.
Dr T Chandrakant.
As detailed
Detailed Answer:
Thanks for your feedback.
Indeed, patient should be taken to the medical/surgical facility for clinical examination, investigations and proper management. It is good that the patient is not on blood thinner or NSAIDs. I also hope that the patient is not taking and herbal products or supplements.
Arterial bleeding is too much and needs immediate attention.
It may be venous or just oozing due to large open space at operative site, opposite surfaces not yet attached to each other. Hence the healing area being very large can ooze more blood tinged fluid. May need vacuum drainage. Of course as decided by the Surgeon.
I hope this answer helps you further.
With Regards.
Dr T Chandrakant.
Above answer was peer-reviewed by :
Dr. Kampana
Dear Dr. Chandrakant,
Thank you for the follow up.
I understand no herbal supplements are being taken now except for iron supplements. Is it ok to take HEME iron with vitamin B and folic acid? Or just iron pills?
Patient has seen a peer surgeon in their office as the operating surgeon is still away. I believe only a visual inspection was done and there were no follow-up blood tests.
The specialist's opinion was that as the lymph nodes were removed this could result in the slower drainage. Is this likely? However, I am still not sure why the fluid is still red in colour and whether lymph node removal could result in the prolonged bleeding?
For opposite surfaces to attach, did the surfaces need to be attached during the surgery or would this normally happen just naturally?
Thank you,
Regards.
Thank you for the follow up.
I understand no herbal supplements are being taken now except for iron supplements. Is it ok to take HEME iron with vitamin B and folic acid? Or just iron pills?
Patient has seen a peer surgeon in their office as the operating surgeon is still away. I believe only a visual inspection was done and there were no follow-up blood tests.
The specialist's opinion was that as the lymph nodes were removed this could result in the slower drainage. Is this likely? However, I am still not sure why the fluid is still red in colour and whether lymph node removal could result in the prolonged bleeding?
For opposite surfaces to attach, did the surfaces need to be attached during the surgery or would this normally happen just naturally?
Thank you,
Regards.
Brief Answer:
As detailed
Detailed Answer:
Thanks for your feedback.
Continue all supplements.
Removing the lymph nodes does not cause blood stained discharge. It can cause lymph drainage which is white in color. No need to attach surfaces as we use vacuum drainage to avoid the development of any cavity in suspected cases where complication is anticipated. Now a days we use vacuum drainage even in hernia surgery.
I hope this answer further helps you.
As detailed
Detailed Answer:
Thanks for your feedback.
Continue all supplements.
Removing the lymph nodes does not cause blood stained discharge. It can cause lymph drainage which is white in color. No need to attach surfaces as we use vacuum drainage to avoid the development of any cavity in suspected cases where complication is anticipated. Now a days we use vacuum drainage even in hernia surgery.
I hope this answer further helps you.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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