Abstract
Decision of relaparotomy is usually become a surgical dilemma as one may encounter dense adhesion before reaching the target site. This may end up with unwanted complication such as iatrogenic injury to adjacent structures as well as bleeding. This is a case of a 46-year-old lady with underlying history of ovarian carcinoma who needed to go for relaparotomy and debulking of recurrent tumour. The attempt to release adhesions was complicated with bleeding at presacral venous plexus. Due to difficulty in achieving haemostasis, bilateral internal iliac artery ligation was done. This procedure did not completely solve the bleeding, so the subsequent step to apply thumbtacks and roller gauze packing were done to create tamponade. The gauzes were removed piece by piece starting from day 8 through small incisional wound without needing to go for another laparotomy.
Highlights
Case PresentationA 46-year-old Malay lady was referred to surgical team during gynaecology team operation for dense adhesion of the recurrent ovarian tumour to the sigmoid colon and distal third of the left ureter
This is a case of a 46-year-old lady with underlying history of ovarian carcinoma who needed to go for relaparotomy and debulking of recurrent tumour
The attempt to release adhesions was complicated with bleeding at presacral venous plexus
Summary
A 46-year-old Malay lady was referred to surgical team during gynaecology team operation for dense adhesion of the recurrent ovarian tumour to the sigmoid colon and distal third of the left ureter. We were summoned to the operating theatre for assessment and assistance in view of the previously mentioned findings
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