Post-bleeding: Causes, Treatment & Help

Postoperative bleeding refers to bleeding that occurs with a delay after a surgical procedure. They can occur in any organ of the body and can have life-threatening effects if not detected in time.

What is postoperative bleeding?

Postoperative hemorrhages refer to bleeding that occurs after a delay following a surgical procedure. They can occur in any organ of the body. Postoperative bleeding is possible in the abdomen as well as after tooth extraction or at external wounds resulting from accidents. They are among the most common surgical risks and can take different forms. Subsequent bleeding often occurs when the anesthetic wears off, because it causes the blood vessels to contract. If the vessels relax, the blood flow is greater again. In the case of dental wounds, for example, spontaneous bleeding or oozing may then occur at the wound. In gynecology, the term postpartum hemorrhage refers to a prolongation of menstrual bleeding, surgical complications, or intermenstrual bleeding. Postpartum hemorrhage also occurs after childbirth. Depending on the extent and organ affected, postpartum hemorrhage is an emergency that must be treated by a physician or in the hospital. Postpartum hemorrhage is particularly common in people with blood clotting disorders or wound infections. High blood pressure increases the risk. Unsuitable suture material, too early stress by the patient, wound healing disorders or hematomas at the suture site can cause a surgical suture to burst. Wound infection due to bacteria entering the wound can cause local inflammation and bursting of the wound. Tonsillectomy, an otherwise harmless procedure in the throat, also carries the risk of postoperative bleeding.

Causes

After a pharyngeal tonsillectomy, the scab comes off about five to eight days after surgery, accompanied by a little bleeding that usually stops on its own. Nevertheless, postoperative bleeding is the most common complication of a pharyngeal tonsillectomy (tonsillectomy) at about 4%. Usually, this unwanted bleeding is stopped by electroagulation. The doctor closes the tissue by burning it at specific points with electricity. Children should be closely monitored after a tonsillectomy, as a coughing fit can also trigger bleeding. Severe bleeding always requires treatment in the hospital. In gynecology, not every postpartum hemorrhage is considered dangerous; bleeding during pregnancy can also have many causes. Intermediate bleeding in early pregnancy is perceived as threatening, but does not necessarily lead to a miscarriage. Spotting in later pregnancy is also usually harmless. However, if bright red, period bleeding occurs, the patient must go to the hospital immediately, and the same applies to bleeding with pain. Some women also experience bloody mucus discharge at the end of pregnancy, which is usually a sign of preterm labor. Contact bleeding may occur after sexual intercourse or an exam because smaller blood vessels may have been injured. This does not always show up right away; sometimes the bleeding does not occur until a day later. Many abdominal surgeries have few complications, but they always carry a risk of postoperative bleeding. After a hysterectomy, bleeding is a common complication and can result from injury to nearby tissue. Postpartum bleeding is also common with cervical tissue removal. During menopause, sudden bleeding can also occur after a long period of time. Then the hormone level has not yet completely settled. They can also be the symptom of a carcinoma. A medical examination is therefore always necessary.

Diseases with this symptom

  • Tumor
  • Abrasion
  • Wound infection
  • Intermediate bleeding
  • Incision
  • Laceration
  • Wound healing disorders
  • Miscarriage
  • Bite wound
  • Crush Wound
  • Blood clotting disorder
  • Spotting

Complications

Postoperative bleeding occurs as a complication of surgery, these can vary in severity depending on the procedure and location. These arise here mainly when the vessels of the operated area have not been completely closed or clotting disorders are present. Depending on the location of the post-operative bleeding, further dangerous consequences may occur.In the area of the throat and pharynx, bleeding is very dangerous. This is because the trachea can become constricted even with small amounts of blood, so that secondary bleeding can lead to respiratory distress and suffocation. Bleeding into the abdomen causes severe stomach pain and can lead to the misdiagnosis of appendicitis. In the worst case, it can lead to hemorrhagic shock, especially with large internal bleeding, which is a medical emergency. There is a drop in blood pressure and an increase in heart rate. In the affected person, important organs are no longer supplied with sufficient blood and can quickly die. Severe blood loss can also lead to the death of the patient if left untreated. If the secondary bleeding continues long after the operation, a large amount of iron is lost. Iron is important for the formation of blood, and this leads to anemia (iron deficiency anemia). The performance of the affected person decreases sharply and he is characterized by chronic fatigue.

When should one go to the doctor?

Postoperative bleeding is a typical complication of surgery and is usually unproblematic. A visit to the doctor is recommended in case of severe bleeding in the area of the throat and pharynx, since in this case there is an acute risk of suffocation. A physician must also be consulted in the case of intensive or long-lasting secondary bleeding. Minor bleeding should be clarified if it leads to greater discomfort such as nausea and vomiting or inflammation in the area of the scar. This is especially true if the bleeding was caused by a fall or unnatural movement. If there is a suspicion that the surgical scar has reopened, this must be discussed immediately with the responsible physician in order to avoid further discomfort and serious complications. Postoperative bleeding accompanied by a drop in blood pressure and an increase in heart rate indicate severe hemorrhagic shock. In this case, emergency medical services should be alerted immediately. Chronic bleeding should be clarified by the attending physician to avoid anemia and deficiency symptoms.

Diseases and complaints

Postoperative bleeding after surgical procedures is a recurrent occurrence. The postoperative bleeding tendency is determined by external factors and depends on the individual constitution of the patient. After surgery, bleeding may be noticed if the recovery room is well monitored and the patient complains of discomfort. The severity of the effects of postoperative bleeding depends on the location of the affected organ and the amount of blood loss. In the case of an external wound, the blood loss can be accurately localized and the wound easily managed by applying a wound dressing. After a short time, scabs form due to blood clotting and the wound heals. If an internal bloodstream is injured, a hematoma forms and the blood does not leak out. Because internal bleeding can go unnoticed for a long time, it is much more dangerous. While external bleeding can also become threatening, it is usually treated more quickly. A blood loss of one liter can be life-threatening for an average adult. For children, even a smaller blood loss poses a risk to life. If only the small blood vessels in the upper layer of the skin are affected, blood loss is usually minor. However, if blood vessels in the subcutaneous layer or the main arteries are injured, even small cuts result in severe blood loss. If arteries are injured, blood escapes in rhythm with the pulse beat. Severe bleeding can lead to unconsciousness and a circulatory collapse. There is a risk of hemorrhage shock. Then the same symptoms appear as with any shock: The affected person freezes, is pale and has cold sweat on the forehead. In the worst case, cardiac arrest is imminent. Hemophilia, on the other hand, is an inherited blood clotting disorder and mainly affects men. Since their blood lacks an important clotting factor in this case, they can bleed to death even from minor injuries if they are not treated correctly immediately.

Outlook and prognosis

Postoperative bleeding can occur with many wounds and does not necessarily lead to complications. Usually, the doctor can use electricity to close the post-operative bleeding relatively well and stop the bleeding in the process. However, if the bleeding is very severe, a hospital must be visited urgently or an emergency doctor must be called.Postpartum bleeding also occurs during sexual intercourse, although it is a harmless symptom. In most cases, the bleeding stops after a short time and does not lead to further pain. If a secondary bleeding is not treated properly, an inflammation or infection may develop there. This will result in pain and an itchy wound. The likelihood of secondary bleeding depends greatly on the region that was operated on. Especially in the area of the lungs or trachea, such bleeding is dangerous and must be treated by a doctor. If the patient loses too much blood, death may result. However, this case rarely occurs. In most cases, secondary hemorrhages can be treated and closed relatively well.

What you can do yourself

Postoperative bleeding is a serious symptom and should in any case first be clarified by a doctor. Accompanying medical treatment, the discomfort can be relieved, for example, by cold compresses and soothing home remedies such as cinnamon or cayenne pepper. Herbal teas regulate blood circulation and reduce inflammation and pain. For secondary bleeding after tonsil surgery, it helps to place ice cubes in the neck or gargle with ice water until the bleeding subsides. If this does not provide relief, an ENT specialist should be consulted. External secondary bleeding can also be reduced by using petroleum jelly or vinegar. For heavily bleeding wounds, cornstarch sprinkled directly on the wound will help stop the bleeding. Sugar and Listerine have a similar effect. Alum has a hemostatic effect and can be applied directly to the wound in the form of a styptic pencil or alum block. In addition, it is recommended to change the dressing and bandage the wound with a sterile bandage. If possible, the affected part of the body should be elevated and spared until the secondary bleeding stops. Acute bleeding can be stopped by applying steady pressure to the wound.