Abstract
Presacral bleeding is a rare but clinically significant event during pelvic dissection. It is characterised by high-volume, rapid bleeding from the presacral venous plexus or the basivertebral veins. It can be prevented by posterior rectal dissection being performed sharply in the plane anterior to the presacral fascia. Bleeding should be dealt with by packing the pelvis and identifying the bleeding point. Management is dependent upon whether the bleeding has arisen from presacral or basivertebral veins. Successful strategies in open- and minimal-access surgery include suture ligation, use of sterile thumbtacks, argon plasma coagulation, haemostatic agents and tamponade with muscle or epiploic appendices.
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Srinivasa, S., Hill, A.G. (2015). Management of Presacral/Pelvic Bleeding. In: Pawlik, T., Maithel, S., Merchant, N. (eds) Gastrointestinal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2223-9_38
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DOI: https://doi.org/10.1007/978-1-4939-2223-9_38
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