An unusual cause of delayed hematoma after carotid endarterectomy: a case report

BMC Surg. 2019 Sep 18;19(1):138. doi: 10.1186/s12893-019-0601-x.

Abstract

Background: Neck hematoma is a complication of carotid endarterectomy, usually occurring in the comparatively early stage postoperatively.

Case presentation: We described a patient developing life-threatening hemorrhage and non-clotting hematoma at a comparatively later stage after CEA. DIC was diagnosed according to the lab results, and the patient underwent re-operation and was supported with blood products until the coagulopathy was corrected. The patient had a history of prostatic hyperplasia and experienced malaise during the hospitalization. Prostate cancer with bone metastases was diagnosed.

Conclusions: This case report describes a rare underlying cause of hematoma after CEA, which reminds us to pay attention to prostate symptoms or related medical history, especially malignancy, in surgical patients, which may result in severe complications.

Keywords: Carotid endarterectomy; DIC; Postoperative hematoma; Prostate cancer; Surgical complications.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Blood Coagulation Disorders / diagnosis
  • Blood Coagulation Disorders / etiology*
  • Blood Coagulation Disorders / therapy
  • Bone Neoplasms / complications*
  • Bone Neoplasms / diagnosis
  • Bone Neoplasms / secondary
  • Endarterectomy, Carotid / adverse effects*
  • Hematoma / diagnosis
  • Hematoma / etiology*
  • Hematoma / therapy
  • Humans
  • Male
  • Neck
  • Prostatic Neoplasms / complications*
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / pathology
  • Reoperation
  • Time Factors
  • Treatment Outcome