Unusual cause of haemorrhage from surgical wound in a child

Area of Science:

• Pediatric Surgery
• Vascular Surgery
• Trauma Surgery

Background:

• Surgical wound hemorrhage has diverse causes, including vascular injury, bleeding disorders, and incomplete hemostasis.
• Pseudoaneurysms and neovascularization are recognized, though less common, sources of bleeding.
• Differential diagnosis of post-traumatic soft tissue masses in children typically includes common injuries.

Purpose of the Study:

• To report an unusual cause of surgical wound hemorrhage in a pediatric patient.
• To highlight the importance of considering less common vascular pathologies in the differential diagnosis of pediatric soft tissue masses.
• To emphasize the need for a high index of suspicion for early diagnosis of surgical site bleeding.

Main Methods:

• Case report of a 9-year-old child presenting with surgical wound hemorrhage.
• Clinical evaluation, diagnostic imaging (e.g., ultrasound, CT angiography), and surgical exploration.
• Review of literature on pediatric wound complications and vascular anomalies.

Main Results:

• The patient experienced significant hemorrhage from a surgical incision.
• Diagnostic workup revealed a pseudoaneurysm and evidence of neoangiogenesis as the source of bleeding.
• The condition was successfully managed surgically.

Conclusions:

• Pseudoaneurysm and neoangiogenesis represent an unusual but critical cause of surgical wound hemorrhage in children.
• A high index of suspicion is essential for prompt diagnosis of these vascular complications.
• These entities should be included in the differential diagnosis of soft tissue masses following blunt trauma in pediatric patients.