DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20183814

Postoperative vault hematoma following vaginal hysterectomy: case reports

Amit Gupta, Tanu Verma, Bharti Gupta, Anju Vij, Rajinder Kumar

Abstract


Postoperative vault hematoma is almost a universal consequence of gynaecologic surgery. It usually occurs after vaginal or abdominal hysterectomy. At one end there can be are minimal collection of peritoneal fluid or blood which is clinically insignificant whereas at the other end is the hematoma and abscess requiring active intervention for the patient to recover. We here present two cases of vault hematoma following vaginal hysterectomy which were reported to our institution in recent times. In both cases hematomas were infected. Ultrasonography was used to accurately identify and define the extent of hematomas. The patients underwent vault exploration and drainage. Post-operative period remained uneventful. Postoperative vault hematoma can be diagnosed in the early postoperative period of gynaecologic surgery. It is important to consider the possibility of vault haematoma in patients with persistent fever and vaginal bleeding after hysterectomy. The hematoma cavity can be easily entered to drain hematoma or abscess completely, expediting the recovery of the patient. Refining surgical techniques will significantly reduce the risk of vault hematoma.

 


Keywords


Hematoma, Hysterectomy, Vault

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References


Chaudhry SM, Anwer S. Presentation and management of vaginal vault hematoma after hysterectomy. J Surg Pakistan. 2016;21(1):35-8.

Dane C, Dane B, Cetin A, Yayla M. Sonographically diagnosed vault hematomas following vaginal hysterectomy and its correlation with postoperative morbidity. Infectious diseases in obstetrics and gynecology. 2007;2007.

Slimani O, Alaoui F, Jayi S, Chaara H, Bouguern H. Postoperative pelvic hematoma an unusual case after surgical treatment of ectopic pregnancy. J Clin Case Rep. 2014;4(422):2.

Kuhn RJ, de Crespigny LC. Vault haematoma after vaginal hysterectomy: an invariable sequel?. Aus NZ J Obstet Gynaecol. 1985;25(1):59-62.

Slavotinek J, Berman L, Burch D, Keefe B. The incidence and significance of acute post-hysterectomy pelvic collections. Clin Radiol. 1995;50(5):322-6.

Rosen DM, Cario GM. Vault haematoma following laparoscopic hysterectomy. Aus NZ J Obstet Gynaecol. 1997;37(2):220-2.

Cheung KW, Pun TC. Vaginal hysterectomies in patients without uterine prolapse: ten-year experience. Hong Kong Med J. 2013.

Thomson AJ, Sproston AR, Farquharson RG. Ultrasound detection of vault haematoma following vaginal hysterectomy. BJOG: Int J Obstet Gynaecol. 1998;105(2):211-5.

Rock JA, Thompson JD, editors. Te Lende’s operative gynaecology. 8th edn. Philadephia: Lippincott-Raven; 1996.

Morris P, El-Toukhy T, Toozs-Hobson P, MA Hefni E. Refining surgical technique to prevent occurrence of vault haematoma after vaginal hysterectomy. J Obstet Gynaecolgy. 2001;21(4):379-82.