Postoperative delayed massive bleeding in gastric cancer: a case report

Area of Science:

• Gastroenterology
• Surgical Oncology
• Vascular Surgery

Background:

• Postoperative delayed bleeding following gastric cancer radical gastrectomy presents a significant clinical challenge due to its low incidence and high mortality.
• Gastric malignancy diagnosis during routine examination necessitates surgical intervention, such as Billroth's I resection.

Observation:

• A 63-year-old female patient experienced sudden hematemesis 24 days post-Billroth's I gastric resection for malignancy.
• Diagnostic imaging revealed an anastomotic fistula, duodenal artery rupture, and abdominal aorta bleeding.

Findings:

• The patient required multiple interventions, including three surgeries and two arterial embolizations, to manage the severe bleeding.
• Successful stabilization and discharge were achieved following comprehensive treatment.

Implications:

• The absence of specific guidelines for managing abdominal pseudoaneurysms post-gastric cancer surgery underscores the need for tailored treatment approaches.
• Early utilization of digital subtraction angiography is crucial for accurate diagnosis and effective treatment planning in such complex cases.
• Prompt diagnosis and intervention are key to improving the success rates of life-saving procedures for delayed postoperative bleeding.