Postconization Bleeding

CLINICAL FEATURES High-grade squamous intraepithelial lesions of the cervix may be treated by loop electrocautery or cold-knife cone. The most common complication of these procedures is bleeding. If delayed hemorrhage occurs, it usually occurs 7 days postoperatively. Bleeding following this procedure can be rapid and severe.

DISPOSITION Visualization of the cervix is the key to controlling such bleeding. Application of Monsel solution is a reasonable first step if it is readily available. If this is not successful, a gynecologist should be consulted for suturing of the bleeding arteriole. Often, the patient must be taken to the operating room for repair because adequate visualization is difficult in the emergency department.

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