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Internal packing in the control of hemorrhage from large retroperitoneal veins
Maciej L Dryjski1, Roman A Litwinski, Constantine P Karakousis
1Department of Surgery, Kaleida Health, Millard Fillmore Hospital, 3 Gates Circle, Buffalo, NY 14209, USA. mdryjski@kaleidahealth.org
Background:
Hemorrhage from large retroperitoneal veins is usually controlled by suturing the venous tear. Infrequently, the extent and location of the tear and amount of hemorrhage preclude successful suturing.
Methods:
In seven patients with severe hemorrhage from large retroperitoneal veins encountered in association with resection of retroperitoneal sarcoma (6) or repair of a ruptured abdominal aortic aneurysm (1), packing of the area with sufficient amounts of Surgicel (Ethicon, Johnson & Johnson, Somerville, NJ) and pressure for one half hour was used.
Results:
All seven patients did not show any bleeding postoperatively and no clinical sequelae developed, with the exception of one patient who developed an abscess requiring drainage.
Conclusion:
Internal packing with Surgicel appears to be reliable in controlling venous hemorrhage not manageable by the standard methods and may be preferable to roll gauze packing.
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