I was operating a large right adrenal cyst which was hemorrhagic with a large number of aberrant venous tributaries draining into inferior vena cava, cyst was debulked. Due to fear of avulsion of tributaries from inferior vena cavaAll the tributaries were carefully ligated individually. The cyst was almost dissected out.All on a sudden torrential hemorrhage occurred. It became like a lake of blood, causing a rapid drop in blood pressure.
Bleeding points at such occasions can't be identified.Any attempt of suturing will make more tears since the patient suddenly became hypotensive.Without wasting a moment, an immediate decision of packing taken. Packing stopped hemorrhage, rapid blood transfusions caused patient normotensive.The immediate threat to life was thwarted by hemorrhage due to packing. At such junctures it is important not to allow bleeding to continue, or, lethal triad will…
