Postoperative
bleeding is a concern for all
patients undergoing
heart surgery, which could be due to surgical causes or coagulation disorder. The
patients at
risk for coagulopathy include those
patients with complex or prolonged
procedures, those exposed to preoperative
anticoagulants and, to a lesser extent,
patients with a preoperatively elevated
prothrombin time and activated clotting
time. However, intraabdominal
bleeding after
cardiac surgery is rare (0.3-2%). As the mortality rate of
patients exposed to these
complications is high (11-59%), timely recognition and prompt management is vital for
patient's
safety and for avoidance of
postoperative complications. Here, we present a case of free intraabdominal
hemorrhage as sequelae of pacing wire insertion in open
heart surgery and its successful management.