Unusual Presentation of a Post-procedural Breast Hematoma: A Case Report.


Journal

In vivo (Athens, Greece)
ISSN: 1791-7549
Titre abrégé: In Vivo
Pays: Greece
ID NLM: 8806809

Informations de publication

Date de publication:
Historique:
received: 08 05 2021
revised: 31 05 2021
accepted: 04 06 2021
entrez: 19 8 2021
pubmed: 20 8 2021
medline: 24 8 2021
Statut: ppublish

Résumé

Hematoma is the most frequent complication after Vacuum-Assisted Breast Biopsy (VABB) in 13% of cases. A direct communication channel with patients eases the diagnosis of VABB complications and ensures treatment at an early stage, as outpatients, in most cases. In 2020, due to the COVID-19 pandemic, we observed a reduction of self-reported postoperative complication leading to delay in the identification of harmful complications, therefore leading to need for more invasive treatment. A 50-year-old patient was admitted to the Emergency Department for dry cough, fever, chest discomfort, dyspnea, and slight confusion four days after VABB. Due to the reported symptoms, the patient was sent to our COVID-19 Emergency Department. The COVID-19 swab was negative. Ultrasound revealed a large hematoma at the biopsy site, with active bleeding. Open evacuation with accurate hemostasis was planned with rapid and complete resolution of the clinical symptoms. After surgery, the patient reported that she intentionally avoided admittance in the hospital due to the risk of COVID-19 infection. The patient was discharged in the first postoperative day and maintained in quarantine for 14 days. In the COVID-19 era due to the risk of hospital cross-infections, reduction of patient-doctor communication could lead to misdiagnosis, delay in recognition of procedural complications thus leading to requirement for invasive treatment, hospitalization, while also further multiplying the risk of COVID-19 infection.

Sections du résumé

BACKGROUND/AIM OBJECTIVE
Hematoma is the most frequent complication after Vacuum-Assisted Breast Biopsy (VABB) in 13% of cases. A direct communication channel with patients eases the diagnosis of VABB complications and ensures treatment at an early stage, as outpatients, in most cases. In 2020, due to the COVID-19 pandemic, we observed a reduction of self-reported postoperative complication leading to delay in the identification of harmful complications, therefore leading to need for more invasive treatment.
CASE REPORT METHODS
A 50-year-old patient was admitted to the Emergency Department for dry cough, fever, chest discomfort, dyspnea, and slight confusion four days after VABB. Due to the reported symptoms, the patient was sent to our COVID-19 Emergency Department. The COVID-19 swab was negative. Ultrasound revealed a large hematoma at the biopsy site, with active bleeding. Open evacuation with accurate hemostasis was planned with rapid and complete resolution of the clinical symptoms. After surgery, the patient reported that she intentionally avoided admittance in the hospital due to the risk of COVID-19 infection. The patient was discharged in the first postoperative day and maintained in quarantine for 14 days.
CONCLUSION CONCLUSIONS
In the COVID-19 era due to the risk of hospital cross-infections, reduction of patient-doctor communication could lead to misdiagnosis, delay in recognition of procedural complications thus leading to requirement for invasive treatment, hospitalization, while also further multiplying the risk of COVID-19 infection.

Identifiants

pubmed: 34410994
pii: 35/5/2957
doi: 10.21873/invivo.12589
pmc: PMC8408686
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2957-2961

Informations de copyright

Copyright © 2021 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

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Auteurs

Gianluca Vanni (G)

Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy.

Domiziana Pedini (D)

Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy.

Marco Materazzo (M)

Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy; marco.materazzzo@ptvonline.it.

Andrea Farinaccio (A)

Cardiac and Thoracic Anesthesia Unit, Tor Vergata University Hospital, Rome, Italy.

Tommaso Perretta (T)

Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy.

Chiara Adriana Pistolese (CA)

Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy.

Oreste Claudio Buonomo (OC)

Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy.

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Classifications MeSH