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Prevention and Treatment of Life-Threatening Bleeding After Thyroid Surgery

Xiwei Zhang, Changming An, Jie Liu, Zhengjiang Li, Pingzhang Tang, Zhengang Xu

Department of Head and Neck Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Science (CAMS), Peking Union Medical College, Beijing, China (mainland)

Med Sci Monit 2015; 21:3682-3689

DOI: 10.12659/MSM.895650

Available online:

Published: 2015-11-27

BACKGROUND: Few reports have discussed life- threatening bleeding that occurs postoperatively in patients who have undergone thyroid surgery. In this article, we discuss the causes, treatment measures, and possible ways of preventing this severe complication.
MATERIAL AND METHODS: From Jan 2002 to Dec 2014 we retrospectively analyzed 7 patients who developed life-threatening bleeding after undergoing thyroid surgery at our center.
RESULTS: Among the group of 7 patients, there was 1 case of superior thyroid artery hemorrhage (STAH), 5 cases of carotid blowout syndrome (CBS), and 1 case of tracheo-innominate fistula (TIF). The STAH was caused by unreliable ligation. All the cases of CBS and TIF were caused by surgical wound infection. Six patients were transferred to the operating room immediately; open surgical treatment was performed on these 6 patients. Out of these 6 patients, 1 patient did not survive the operation, and hemorrhage was successfully controlled in 3 patients. The remaining 2 patients again experienced bleeding even after undergoing open surgery. Only 1 patient developed long-term neurological complications.
CONCLUSIONS: Infection is the most common cause of life-threatening bleeding that occurs postoperatively in some patients who have undergone thyroid surgery. Early surgical intervention can save the lives of these patients without causing any severe neurological complications.

Keywords: Arteries, Adult, Blood Loss, Surgical - prevention & control, Parathyroid Glands, Thyroid Gland - surgery, Thyroid Neoplasms - surgery