Anterior compartment resections of the thigh and postoperative bleeding
Mahmoud N. Kulaylat and John L. Butsch
World Journal of Surgical Medical and Radiation Oncology 2012, 1:9
Introduction: In a compartment resection of the anterior thigh which includes the vastus lateralis, as the posterior attachment of the muscle to linea aspera is divided the perforator branches of the profunda may be divided and occasionally retract into in accessible locations behind the femur where they may stop temporarily bleeding through contraction giving the false impression of hemostasis.
Case report: A 28-year old man had a history of a peripheral neuroectodermal tumor in the left anterolateral thigh located in the substance of vastus lateralis and vastus intermedius and two nodules in the left lung. After the neoadjuvant chemotherapy resection of the tumor was carried out. At the end of the procedure the left lateral thigh was noted to be swollen and blood was oozing between the skin staples. The incision was opened, and a large hematoma evacuated. Small bleeding points were coagulated. Bleeders on the muscle surface were suture-ligated. There was also arterial bleeding, with no visible vessel, behind the linea aspera.
Discussion: The techniques to avoid this type of bleeding or to control it at reoperation, if it occurs postoperatively, are described.