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JOSEPH J. LITTELL, M.D.
Santa Rosa, Calif.

AMA Arch Otolaryngol. 1955;62(3):331-332.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Bleeding which occurs from the 3rd to the 14th day after an operation has always been a source not only of great annoyance and worry to me but also something of a mystery. Bleeding at this time is usually from a capillary bed rather than from a big vessel, has a strong tendency to recurrence over several days' time, and is difficult to control. One cannot pick up a bleeding point with a hemostat and tie it off. Caustics are sometimes helpful. Pressure on the area, especially with epinephrine, controls it as long as the epinephrine is effective and/or the pressure is maintained. But, as in the nose or the adenoid region, it is easy for a packing to slip a little or not be on the exact spot. In that case, one can expect an exasperating call to the effect that the area is bleeding again. After the 14th . . . [Full Text PDF of this Article]

Footnotes
Submitted for publication May 2, 1955.

Since the article was written, and as of Sept. 10, 1955, I have seen three cases of postoperative bleeding which required an unilateral anterior nasal pack. One was an apparently eroded spurting vessel in the incisor canal, injured when its bony surroundings were chiseled away during a submucous resection. The antihistamines could not be expected to control this. Case 2 was from a submucous resection of a lower turbinate in a profoundly allergic boy in whom the antihistamines were ineffective in reducing a tremendous vasomotor swelling. The third case showed persistent oozing from the tip of an injured middle turbinate in a man with a blood pressure of 210/114.

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