Large port site hematoma following laparoscopic surgery and its management

Abstract

Background: Acute hemorrhage and delayed hematoma formation from laparoscopic port sites are uncommon but can be potentially significant complications. They become evident in days 2 to 6 postoperatively, manifesting as visible bruises, excessive pain, or an asymptomatic drop in hematocrit. Bleeding into the abdominal wall leading to giant abdominal wall hematoma requiring blood transfusion, prolonged hospitalization, and emergency surgical procedures is rare. Case description: A woman who had successful second look laparoscopic surgery following debulking surgery for ovarian malignancy developed a large subcutaneous hematoma. She presented after 25 days of discharge from the hospital and was managed by incision and drainage. Results: Exploration of the wound was done with evacuation of blood clots amounting to 300 cc. There was no identifiable bleeding point. The patient had an unremarkable postoperative course after the incision and drainage and was discharged after 2 days. Conclusion: Sound techniques of port placement along with a thorough understanding of the anterior abdominal wall anatomy are crucial to prevent laparoscopic port site hematoma.