Indexing Title: CLEYSONs Medical Anecdotal Report  [04-1]

MAR Title: Patient with acute blood loss; S/P Hemorroidectomy

Date of Medical Observation: April 26, 2004

Narration:

When I arrived at the hospital last April 26, 2004, a collegue of mine told me that my patient, SP 47/F came to ER early in the morning (eleven days after I did a hemorrhoidectomy on her for a Grade III mixed hemorrhoids) complaining  of bleeding per anus. CBC and blood typing was already requested and waiting for the results. I went to the ER and talked to her, I left her for a while and went to a patient three beds from her, then I heard her daughter calling me and told me that shes bleeding again, so I came to them, saw her standing, blood clots and fresh blood at her feet. She went weak, so we lie her down, BP was taken it was 90/60,  another line was inserted and we fast drip about 1 liter of plain LR, 2 Units of fresh whole blood was crossmatched, once the first blood was hooked we directed the patient to OR. On exploration of the anal area, we noted that major bleeding was at the hemorrhoidal stump (2 was noted). We ligate the stump and control the other minor bleeding area.

    After the operation, I told her our findings and what have been done to the bleeding. Stool softener was ordered. we built a good rapport, and I didn't saw anger on her face as well as her relatives.

Insights(discovery, stimulus, REINFORCEMENT)

     As a surgeon, we should always keep in mind that we are not GOD nor a perfect human being, anything can happen to us as well as our patients.  We are prone to complaints and even medico-legal suits. The right knowledege and the right skills as well as a GOOD RAPPORT with the patients as well as his relatives are methods to prevent complaints.