Endovascular management of two episodes of late intraperitoneal hemorrhage following laparoscopic gastrectomy for gastric cancer

Postoperative delayed massive bleeding in gastric cancer: a case report

BACKGROUND

Postoperative delayed bleeding of gastric cancer is a complication of radical gastrectomy with low incidence rate and high mortality.

CASE PRESENTATION

This case report presents the case of a 63-year-old female patient of Mongolian ethnicity who was diagnosed with gastric malignancy during a routine medical examination and underwent Billroth's I gastric resection in our department. However, on the 24th day after the surgery, she was readmitted due to sudden onset of hematemesis. Gastroscopy, abdominal CT, and digital subtraction angiography revealed postoperative anastomotic fistula, rupture of the duodenal artery, and bleeding from the abdominal aorta. The patient underwent three surgical interventions and two arterial embolizations. The patient's condition stabilized, and she was discharged successfully.

CONCLUSION

Currently, there are no specific guidelines for the diagnosis and treatment of pseudoaneurysms in the abdominal cavity resulting from gastric cancer surgery. Early digital subtraction angiography examination should be performed to assist in formulating treatment plans. Early diagnosis and treatment contribute to an improved overall success rate of rescue interventions.

Clinical characteristics of and prevention strategies for delayed hemorrhage following radical gastrectomy for gastric cancer

BACKGROUND

Delayed massive hemorrhage after gastric cancer surgery is clinically rare, but it is very dangerous once it occurs.

CASE SUMMARY

The clinical data of three patients who underwent radical gastrectomy for gastric cancer were retrospectively analyzed and the preventive strategies for this rare condition are summarized.

CONCLUSION

The causes of hemorrhage after radical gastrectomy are complicated and the methods of hemostasis should be flexibly chosen according to different causes. Computed tomography, digital substraction angiography, and endoscopy can be used for diagnosis and treatment. Intraoperative meticulous manipulation and postoperative close monitoring and effective support are essential for reducing delayed massive hemorrhage after gastric cancer surgery.