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Hematoma Risk after Hysterectomy

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Hematoma Risk after hysterectomyI’ve heard that you can have a hematoma after a hysterectomy. What is a hematoma and how is it treated?

A hematoma is a collection of blood outside of a blood vessel. It occurs because the wall of a blood vessel wall, artery, vein, or capillary, has been damaged, and blood has leaked into tissues where it does not belong. A bruise, for example, is actually a hematoma.

One reason that your surgeon had you stop taking medications such as aspirin and blood thinners prior to your surgery is to decrease the risk of hematomas. Hematomas can occur in any part of the body. During surgery, your surgeon will seal blood vessels as they are cut. S/he will double check those seals before closing the incision. If the clot sealing a blood vessel comes loose, bleeding can occur. This bleeding could lead to the formation of a sac of blood in the surgical site and surrounding tissues—this is a hematoma. It is not the same as a blood clot in a vein, and it doesn’t cause blood clots.

Increases in blood pressure and heart rate after surgery can trigger the chances of hematoma. These triggers include exercise, straining, vomiting, stress and alcohol. This is part of the reason it is so important to follow your doctor's instructions after your hysterectomy.

The symptoms of a hematoma are most frequently swelling and inflammation. There may be pain and a feeling of fullness in the affected area. Depending on the site, there may even be visible bruising. A common complication of all hematomas is the risk of infection. Since there is no blood supply to a hematoma—it is a collection of old blood—there is a risk of bacteria colonizing the site. If the hematoma becomes large enough, it can compress tissues and prevent oxygen from reaching surrounding tissue. This could cause tissue to die and increase risks of wound separation and necrosis.

If infection should develop in the wound, the signs and symptoms might be increasingly severe pain, a fever of 101 degrees (Fahrenheit) or more, swelling with surrounding redness, and pus. If any of these signs appear, notify your physician to make sure there are no additional problems.

Treatment for a hematoma depends on its severity. Mild cases will dissolve on their own after a couple of days. Severe cases, where the hematoma enlarges, will require a surgery to drain the accumulated blood and clamp down the blood vessels if there is continued bleeding. Your surgeon may require an X-ray, ultrasound, or CT scan to confirm that a hematoma is present. The surgeon may prescribe some medications to relieve pain or discomfort. Additionally, some medications may be prescribed to dilute the clot.

This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

11-10-2011 - 07:02 AM


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