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Had Culdoplasty. Ended Up With Internal Bleeding. Severe Lower Rib Cage Pain, Hypo Tension And Severe Vertigo. Suffer Abdominal And Vaginal Pain. Cure?
Dr. Grief,
I had a vag hyst w/ BSO and culdoplasty 8-20-13. Long story short, I ended up with internal bleeding and required 2 units of blood and a iron transfusion. My HGB went from normal to 6.7 post-op accompanied by severe lower rib cage pain, hypotension 87/49, severe vertigo, ringing of the ears, etc. etc. The Dr. voiced that he felt my issues were r/t dehydration and attempted to correct my issues with fluids only. I am an RN and "insisted" upon a blood transfusion. He stated he was comfortable with the transfusion, if I was ok with the risks?!?! When I requested my primary Dr. consult with him regarding my case, he seemed ummm....offended. Finally the day of my planned discharge, my GYN voiced my HGB had gone up to 7.7, and basically felt I was good to go. It took an act of GOD to get a CT, which identified I had indeed bleed internally. Nothing was ever discussed with me about going back in to fix anything, they are going to monitor me which lab tests which I had drawn today. I understand you run the risk of internal bleeding with any surgery, but was my outcome really typical of what I should expect? Another question is this is day 6 post-op, I am still having quite a bit of internal abdominal pain (right left lumbar and umbilical regions), tenderness, ascites, an 18 pound weight gain post-op, and now I'm having sharp vaginal pains. Is this to be expected?
I had a vag hyst w/ BSO and culdoplasty 8-20-13. Long story short, I ended up with internal bleeding and required 2 units of blood and a iron transfusion. My HGB went from normal to 6.7 post-op accompanied by severe lower rib cage pain, hypotension 87/49, severe vertigo, ringing of the ears, etc. etc. The Dr. voiced that he felt my issues were r/t dehydration and attempted to correct my issues with fluids only. I am an RN and "insisted" upon a blood transfusion. He stated he was comfortable with the transfusion, if I was ok with the risks?!?! When I requested my primary Dr. consult with him regarding my case, he seemed ummm....offended. Finally the day of my planned discharge, my GYN voiced my HGB had gone up to 7.7, and basically felt I was good to go. It took an act of GOD to get a CT, which identified I had indeed bleed internally. Nothing was ever discussed with me about going back in to fix anything, they are going to monitor me which lab tests which I had drawn today. I understand you run the risk of internal bleeding with any surgery, but was my outcome really typical of what I should expect? Another question is this is day 6 post-op, I am still having quite a bit of internal abdominal pain (right left lumbar and umbilical regions), tenderness, ascites, an 18 pound weight gain post-op, and now I'm having sharp vaginal pains. Is this to be expected?
posted on
Fri, 30 Aug 2013
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sat, 31 Aug 2013
Answered on
Sat, 31 Aug 2013
Last reviewed on
Hello
Thanks for your query
In a nutshell - No, this is not to be expected, nor is this a ' normal ' outcome.
Following any hysterectomy, and vaginal hysterectomy in particular, there is always some amount of blood collection - hematoma , so to speak, at the vault, wherein the stitches are bunched up.
This is the collected blood from the entire abdomen, and it gets resolved in time.
For you to have hypotension necessitating blood transfusion, there has to be SIGNIFICANT collection inside.
The ascites, tenderness, vaginal spiking pains and weight gain also point to a third compartment loss, that is, significant amount of internal bleeding.
Ideally a drain should be inserted, to measure the collection, also the CT would have quantified the bleed.
If it doesnt resolve on its own with antibiotics and expectant management, re exploration might be in order.
All the best.
Thanks for your query
In a nutshell - No, this is not to be expected, nor is this a ' normal ' outcome.
Following any hysterectomy, and vaginal hysterectomy in particular, there is always some amount of blood collection - hematoma , so to speak, at the vault, wherein the stitches are bunched up.
This is the collected blood from the entire abdomen, and it gets resolved in time.
For you to have hypotension necessitating blood transfusion, there has to be SIGNIFICANT collection inside.
The ascites, tenderness, vaginal spiking pains and weight gain also point to a third compartment loss, that is, significant amount of internal bleeding.
Ideally a drain should be inserted, to measure the collection, also the CT would have quantified the bleed.
If it doesnt resolve on its own with antibiotics and expectant management, re exploration might be in order.
All the best.
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