Haemoabdomen

Question 1

First thing you need to do when there is haemoabdomen?

Answer 1

Call for assistance
- alert the anaesthetist or nurse

Question 2

Second think you need to do when there is haemoabdomen

Answer 2

Identify the source

Question 3

What do we need to do in order to prepare to find the source of haemorrhage?

Answer 3

Extend the incision - cranially and/or caudally

Question 4

Where does haemorrhage most typically originate from?

Answer 4

Ovarian pedicles
Uterine stump
or Broad ligament

Question 5

How do you reveal the left ovarian pedicle?

Answer 5

Along the abdominal wall, identify the descending colon and move it from left to right to reveal the left sub lumbar fossa and left ovarian pedicle

Question 6

What effect can anaesthetic agents have on the spleen ?

Answer 6

Can enlarge the spleen

Question 7

What structure blocks the right ovarian pedicle?

Answer 7

The duodenum

Question 8

Where is the uterine stump located?

Answer 8

Between the neck of the bladder and the rectum
(may need to extend the incision caudally and retroflex the bladder to reveal the stump)

Question 9

What do you use to remove excess blood from the surgical field?

Answer 9

Suction or laparotomy swabs/ gauze

Question 10

What to do is haemorrhage is marked and visualisation is hampered?

Answer 10

Following removal of excess blood apply gentle pressure with gauze for several minutes (upto 5 may be required)
- will help reduce the level and rate of haemorrhage and facilitate visulisation

Question 11

What need to be done after source is identified and controlled?

Answer 11

Additional ligatures placed for control
Evaluation of remaining regions to ensure no second site of haemorrhage