The occurrence of sudden intra-abdominal hemorrhage several days after surgery is distressing and puzzling. In this report, the case histories of three patients are used to indicate a set of circumstances which may produce late postoperative hemorrhage from the hepatic artery, from other branches of the celiac axis, or at the site of ligation of branches of other large intra-abdominal arteries. Subsequent discussion will indicate the belief that the fundamental cause of these instances of arterial rupture is arteritis. Evidence of features common to the delayed hemorrhage from war wounds adjacent to large vessels of the extremities and from carotid arteries subsequent to neck dissections will be pointed out.
The recognition of this complication is important, since accurate identification of the site of hemorrhage and its control may be life-saving.
Report of Cases
—A 77-year-old white woman was seen at Roswell Park Memorial Institute in April, 1954, with