Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXX: Reoperative Abdominal Surgery
United States Department of Defense
Peer Review Status: Internally Peer
Reviewed
Late hemorrhage in abdominal wounds is seen when an infectious process erodes a blood vessel of significant size. This occurs most often in the retroperitoneum when a hematoma was not explored. When it results from a missile wound, the area is contaminated and cellulitis or abscess formation reactivates bleeding by clot resolution or vessel erosion. Undetected wounds in the fixed portion of the colon, duodenum, pancreas, and retroperitoneurn (with eventual infection) and hemorrhage from the lumbar venous plexus are most troublesome and may be fatal. Since such hemorrhage is usually profuse, operation, although mandatory, may not be effective.
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