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Unusual presentation of a life-threatening intraperitoneal haemorrhage after elective inguinal hernia repair
  1. Kenrick Kai Chi Chan,
  2. Shahab Khan and
  3. Christopher Lewis
  1. Surgical Emergency Unit, John Radcliffe Hospital, Oxford, UK
  1. Correspondence to Mr Kenrick Kai Chi Chan, kaichi{at}


A 57-year-old man who was hypotensive at induction of anaesthesia was having intermittent episodes of hypotension after an uncomplicated and relatively bloodless open inguinal hernia repair of a large left-sided hernia . His hypotension was responsive to small fluid boluses. He did not show any tachycardia, had no abdominal pain, no signs of bruising or bleeding in his abdomen, flanks, or scrotum. Remained clinically well and alert throughout until being transferred to a tertiary centre. Eventually became haemodynamically unstable approximately 6 hours postoperatively. CT angiogram showed a large haemoperitoneum with active bleeding. Diagnostic laparoscopy revealed an actively bleeding inferior epigastric artery which was stopped. The patient received 2 units of red blood cells and made a full recovery.

  • radiology
  • general surgery
  • surgery
  • sports and exercise medicine

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  • Contributors SK: SpR providing revisions and corrections for submission. CL: supervising consultant and assistance with abstract.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.