Delayed re-bleeding after removal of a radial arterial cannu
Hematoma after arterial cannulation is not so very rare but tends to occur during cannulation and immediately after decannulation. Published in the JA Clinical Reports, the authors report a case of delayed re-bleeding after the removal of a radial arterial cannula.

A 74-year-old woman underwent revision total arthroplasty under general anesthesia with epidural anesthesia. She had no comorbidities and regularly took loxoprofen sodium hydrate. Examinations before the operation had no abnormal findings. Her right radial artery was punctured and cannulated uneventfully. The amount of bleeding was 320 mL, and she received 160 mL of autologous fresh-frozen plasma.

A nurse noted bleeding from the puncture site 13 h after the operation. She compressed the site by hand and called a duty doctor, who advised watchful waiting. They confirmed the stop of bleeding and noticed slightly edema and internal hemorrhaging around the puncture site.

The next day, internal hemorrhaging and edema from the fingers to the middle of the upper arm were noted. Her right forearm was stiff and swollen, but her hand movement was not restricted. She noted no paralysis or paresthesia. The pulse oximeter detected normal waves on her right fingers.

Based on these symptoms, compartment syndrome was not suspected. The circumferences of her forearm at two points (proximal wrist joint and distal elbow) were checked eight times over 2 days, with no increase in size noted. The internal hemorrhaging and edema were gradually diminished.

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