A 60yo pt recovering from a surgery for toxic goiter is found to be hypotensive, cyanosed in the
the RR. Exam: tense neck. There is blood oozing from the drain. What is the most likely dx?
a. Thyroid storm
b. Reactionary hemorrhage
c. Secondary hemorrhage
d. Primary hemorrhage
e. Tracheomalacia
answer B
(1) During the first 48 hours (reactionary haemorrhage) because a clot
in a vessel has been displaced, or a ligature has slipped. Or, (2) 8
to 14 days later (secondary haemorrhage) when the wound has become
infected and eroded a vessel, usually quite a small one, sometimes a
larger one.
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