Kaya et al. Journal of Medical Case Reports 2011, 5:172 http://www.jmedicalcasereports.com/content/5/1/172 C A S E R E P O R T JOURNAL OF MEDICAL CASE REPORTS Open Access Prolonged venous bleeding due to traditional treatment with leech bite: a case report Bulent Kaya*, Orhan Bat, Nuriye Esen Bulut, Hasan Altun and Kemal Memisoglu Abstract Introduction: The medicinal leech, Hirudo medicinalis, has been used in the treatment of many diseases for thousands of years. In Turkey, it is used most commonly in the management of venous diseases of lower extremities. Case presentation: A 25-year-old Turkish woman presented to our emergency room with bleeding from her left leg. She had been treated for varicose veins in her lower extremities with leeches about 24 hours before admission to the emergency room. The bleeding was controlled by applying pressure with sterile gauze upon the wound, and she was discharged. She returned after four hours having started bleeding again. Hemostasis was achieved by vein ligation under local anesthesia. Conclusions: Leech bite should be evaluated as a special injury. Prolonged bleeding can be seen after leech bites. In such cases, hemostasis either with local pressure or ligation of the bleeding vessel is mandatory. Introduction Leeches are bloodsucking worms usually found in places with fresh water. There are two species of therapeutic leeches, Hirudo medicinalis (European medical leech) and Hirudo michaelseni. H. medicinalis is about 10 cm in length and 2 g in weight. They have been used for the treatment of many diseases as far back as 2,500 years ago. Headaches, hemorrhoids, and mental illness are some of the disorders that have been treated with leeches. Treatment with leeches is referred to as hirudothera- phy in modern medicine. Today, medicinal leech ther- apy is mainly used in plastic surgery and reconstructive surgery for tissue flap salvage [1]. Medicinal leech ther- apy in Turkey is a traditional treatment for venous dis- orders of the lower extremities. Most patients get symptomatic relief with this treatment. Leeches are placed onto the lower extremities and they suck the accumulated blood from the dilated veins. Here, we report the case of a patient with prolonged bleeding after medicinal leech bites. We were able to control the bleeding in our patient by ligation of the punctured, dilated veins with an operation under local * Correspondence: drbkaya@yahoo.com Fatih Sultan Mehmet Training And Research Hospital, Department of General Surgery, Atasehir, Istanbul, Turkey anesthesia. We believe that this is the first case report in the English literature concerning prolonged bleeding after leech bite in the treatment of venous disease of the lower extremities. Case presentation A 25-year-old Turkish woman presented to the emer- gency department with bleeding from her left leg. She had been treated with leeches for varicose veins in her lower extremities about 24 hours prior to her admission. The leeches had stayed in place for three to four hours in the posterior region of her legs. Her medical history was otherwise unremarkable. There was no bleeding dia- thesis and she was not taking any medication. On physi- cal examination, she was a healthy woman with no findings of distress. Her vital signs were normal. There was oozing bleeding from her left leg. Punctured skin and bleeding, dilated veins were detected (Figure 1). There was no ecchymosis, swelling, or erythema. The bleeding was controlled by compression applied with sterile gauze, and our patient was subsequently discharged. After four hours, our patient was again admitted to our emergency department with recurrent bleeding. The wound was cleaned with antiseptic solution. On physical examination, there were dilated veins with bleeding. The © 2011 Kaya et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.