OUTCOME OF DELAYED HEMORRHAGE FOLLOWING SURGICAL HEMORRHOIDECTOMY

Delayed hemorrhage following surgical hemorrhoidectomy is a well-recog nized complication. Emergency treatment may include suture ligation, a nal packing, or other means of tamponade. At the Lehigh Valley Hospita l, 27 patients were seen with the complication of delayed hemorrhage o ver an eight-year period from 1983 to 1990, for an incidence of 0.8 pe rcent. Twenty-five patients (93 percent) underwent surgery primarily f or hemorrhoidal disease; one patient had hemorrhoids removed in additi on to a sphincterotomy for anal fissure, and the remaining patient had hemorrhoidectomy with fistulotomy. The mean interval from the operati on to hemorrhage was six days. Treatment modalities included bedside a nal packing in 20 patients (74 percent), observation alone in five pat ients (18 percent), and suture ligation in the operating room in two p atients. Anal packing was successful in controlling postoperative hemo rrhage in 20/20 patients, but late complications requiring reoperation developed in 15 percent.