Conversation: The conversation between human and AI assistant.
[|Human|] hi we had an open appendicetomy performed in a young male which was retro colic in position tough one para colic gutter was opened and removed hemostasis attained, drain placed and closed pt had persisitent tacycardia next day on POD 2 as tacycardia persisted BP normal abdomen soft Bowel sounds persent he had a fall while going to rest room pulled drain off during the fall blood was trickling from wound site so suspecting an internal bleed he was taken up for emergency surgery there were clots in right hypochondrium and pelvic region totaly 2 and 1/2 litres blood was present in peritoneum cavity. thorugh laprotomy done no bleeder found except for muscle ooze from the previous mcburney incision site what could be the reason for so much bleeding
[|AI|]  helloThanks for query. You have done appendectomy and removed appendix which was in retro cecal and needing to do extensive dissection and putting a Chat Doctor. The hematoma could have been due to bleeding from 1) Appendicular artery which could have been sealed off .2) Oozing from the raw area of retro peritoneum created due to dissection of retrocaecal appendix 3) Bleeding from the unnoticed bleeder from muscles of the abdominal wall 4) Patient may have some bleeding disorder. Do not worry this does happen once in a while even in best hands and gets settled within 3-4 days.