Life-threatening bleeding after mastectomy and deliverance by a single suture: A case-report

Abstract

Postoperative bleeding after mastectomy is rarely a life-threatening complication. However, it can be fatal without treatment, particularly in patients taking antithrombotic medications. We present a case of 84-year-old woman with atrial fibrillation and apixaban medication, who developed breast cancer requiring mastectomy. The patient experienced severe post-operative bleeding on the fifth postoperative day, with first symptoms being disorientation, stomachache, and unstable hemodynamics. A contrast-enhanced computed tomography revealed an active bleeding site superficially in the skin flap. Unfortunately, the patient had to face a two-hour delay before emergency surgery could be performed and the oncall surgeon decided to attempt an unconventional treatment. The source of the bleeding was pinpointed using Doppler ultrasound in the emergency room, and the artery was occluded with a large needle and a figure-of-eight suture. (c) 2025 The Author. Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ )