[Postoperative hemorrhage]

Postoperative hemorrhage is the second most frequent indication for early relaparotomy. The incidence depends on the level of care in a given hospital. It is highest, therefore, in institutions delivering maximal care with many trauma cases. We performed 3443 laparotomies from January 1988 to March 1991. 214 (5.9%) patients had to be reoperated, 48 of them because of postoperative bleeding. This amounts to 1.3% of the total number of laparotomies. Bleeding was identified through drains, ultrasonography or endoscopy, ultrasonography having the highest sensitivity and specificity. Total mortality was 30%. Analysis of the literature shows that mortality is lowest when relaparotomies are performed on 3%-6% of patients.