Difference between revisions of "Haemorrhage"

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'''Haemorrhage/bleeding''' is [a]n abnormal escape of blood from an artery, a vein, an arteriole, a venule or a capillary network. Haemorrhage may occur into a body cavity or organ, into tissues such as muscles, or externally by way of a wound. Internal haemorrhage often causes a HAEMATOMA. Severe haemorrhage results in dangerous loss of circulating blood volume and there may be insufficient to supply the heart muscle and the brain. This is inevitably fatal unless a rapid transfusion of blood is given. Insufficient circulating fluid causes the syndrome of surgical [[Shock| SHOCK]] for which fluid replacement is urgently needed. This need not be whole blood; an infusion of salt water (saline) can save life.<ref>{{REFweb
+
[[File:Bleeding finger.jpg|thumb|Bleeding wound in the finger<br>Other names: Hemorrhaging, haemorrhaging]]
 +
'''Haemorrhage (bleeding)''' is [a]n abnormal escape of blood from an artery, a vein, an arteriole, a venule or a capillary network. Haemorrhage may occur into a body cavity or organ, into tissues such as muscles, or externally by way of a wound. Internal haemorrhage often causes a HAEMATOMA. Severe haemorrhage results in dangerous loss of circulating blood volume and there may be insufficient volume to supply the heart muscle and the brain. This is inevitably fatal unless a rapid transfusion of blood is given. Insufficient circulating fluid causes the syndrome of surgical [[Shock| SHOCK]] for which fluid replacement is urgently needed. This need not be whole blood; an infusion of salt water (saline) can save life.<ref>{{REFweb
 
  |url=https://medical-dictionary.thefreedictionary.com/H%c3%a6morrhage
 
  |url=https://medical-dictionary.thefreedictionary.com/H%c3%a6morrhage
 +
|title=Haemorrhage
 +
|publisher=The Free Dictionary
 +
|date=2004
 +
|accessdate=2022-01-20
 +
}}</ref>
 +
 +
==Haemorrhage after circumcision==
 +
Neonatal circumcision is an elective, medically-unnecessary, non-therapeutic [[amputation]] of the healthy [[foreskin]] that is done only after parents sign a [[circumcision consent form]]. It exposes an infant to surgical risks, but does not treat or prevent disease.<ref name="deacon2022">{{REFjournal
 +
|last=Deacon
 +
|first=Matthew
 +
|init=M
 +
|author-link=
 +
|last2=Muir
 +
|first2=Gordon
 +
|init2=G
 +
|author2-link=
 +
|etal=no
 +
|title=What is the medical evidence on non-therapeutic child circumcision?
 +
|journal= Int J Impot Res
 +
|date=2022-01-08
 +
|url=https://www.nature.com/articles/s41443-021-00502-y
 +
|pubmedID=34997197
 +
|DOI=10.1038/s41443-021-00502-y
 +
|accessdate=2022-02-01
 +
}}</ref>
 +
 +
[[Circumcision]] is an [[Amputation| amputative]] surgical operation that severs arteries and veins as it amputates the [[foreskin]]. As with any surgical operation, haemorrhage is an expected complication of surgery.<ref name="kaplan1983">{{REFjournal
 +
|last=Kaplan
 +
|first=George W.
 +
|init=GW
 +
|author-link=George W. Kaplan
 +
|title=Complications of circumcision
 +
|journal=Urol Clin N Amer
 +
|date=1983-08
 +
|volume=10
 +
|issue=3
 +
|pages=543-9
 +
|url=http://www.cirp.org/library/complications/kaplan/
 +
|quote=
 +
|pubmedID=6623741
 +
|pubmedCID=
 +
|DOI=
 +
|accessdate=2022-01-20
 +
}}</ref><ref name="williams-kapilla1993">{{REFjournal
 +
|last=Williams
 +
|init=N
 +
|author-link=
 +
|last2=Kapilla
 +
|init2=L
 +
|author2-link=
 +
|etal=no
 +
|title=Complications of circumcision.
 +
|journal=Brit J Surg
 +
|location=
 +
|date=1993-10
 +
|volume=80
 +
|issue=10
 +
|pages=1231-6
 +
|url=http://www.cirp.org/library/complications/williams-kapila/
 +
|quote=
 +
|pubmedID=8242285
 +
|pubmedCID=
 +
|DOI=10.1002/bjs.1800801005
 +
|accessdate=2022-01-20
 +
}}</ref>
 +
 +
Strong haemorrhage after a circumcision of a boy was the trigger for the [[Cologne circumcision court judgment]] in 2012.
 +
 +
The clotting ability of the blood is ''not'' tested prior to non-therapeutic infant circumcision as it is thought be unnecessary.<ref>{{REFjournal
 +
|last=Eroglu
 +
|first=
 +
|init=E
 +
|author-link=
 +
|last2=Sözmen
 +
|first2=
 +
|init2=BO
 +
|author2-link=
 +
|last3=Kayiran
 +
|first3=
 +
|init3=SN
 +
|author3-link=
 +
|etal=yes
 +
|title=Evaluation of coagulation tests before newborn circumcision: is it necessary?
 +
|trans-title=
 +
|language=
 +
|journal=Blood Coagul Fibrinolysis
 +
|location=
 +
|date=2016-03
 +
|volume=27
 +
|issue=2
 +
|article=
 +
|page=
 +
|pages=
 +
|url=https://journals.lww.com/bloodcoagulation/Abstract/2016/03000/Evaluation_of_coagulation_tests_before_newborn.10.aspx
 +
|archived=
 +
|quote=
 +
|pubmedID=26523913
 +
|pubmedCID=
 +
|DOI=10.1097/MBC.0000000000000399
 +
|accessdate=2022-02-01
 +
}}</ref>
 +
 +
===Statistics===
 +
 +
Feinberg et al. (2010) collected data on 537 collective [[Gomco]] circumcisions. They found 24 bleeds (4.47%). Bleeding was significantly associated with lack of operator experience.<ref name="feinberg2010">{{REFjournal
 +
|last=Feinberg
 +
|first=Arthur N.
 +
|init=
 +
|author-link=
 +
|last2=Brust
 +
|first2=Rita A.
 +
|init2=
 +
|author2-link=
 +
|last3=Walker
 +
|first3=Travis A.
 +
|init3=
 +
|author3-link=
 +
|etal=no
 +
|title=Bleeding at Circumcision: Patient or Operator Issue?
 +
|trans-title=
 +
|language=
 +
|journal=Clin Pediatr (Phila)
 +
|location=
 +
|date=2010-08
 +
|volume=49
 +
|issue=8
 +
|article=
 +
|page=
 +
|pages=760-3
 +
|url=https://journals.sagepub.com/doi/abs/10.1177/0009922810364658
 
  |archived=
 
  |archived=
−
  |title=Haemorrhage
+
|quote=
 +
|pubmedID=20522619
 +
|pubmedCID=
 +
|DOI=10.1177/0009922810364658
 +
|accessdate=2022-01-21
 +
}}</ref>
 +
 
 +
Heras et al. (2018) collected data on 1,115 circumcisions. They found 41 complications (3.9%), all involving haemorrhage. Three patients required sutures.<ref name="heras2018">{{REFjournal
 +
|last=Heras
 +
|first=Andrea
 +
|init=
 +
|author-link=
 +
|last2=Vallejo
 +
|first2=Victoria
 +
|init2=
 +
|author2-link=
 +
|last3=Pineda
 +
|first3=Marcela L.
 +
|init3=
 +
|author3-link=
 +
|last4=Jacobs
 +
|first4=Allan J.
 +
|init4=
 +
|author4-link=
 +
|last5=Cohen
 +
|first5=Lourdes
 +
|init5=
 +
|author5-link=
 +
|etal=no
 +
  |title=Immediate Complications of Elective Newborn Circumcision
 
  |trans-title=
 
  |trans-title=
 
  |language=
 
  |language=
 +
|journal=Hosp Pediatr
 +
|location=
 +
|date=2018-10
 +
|volume=8
 +
|issue=10
 +
|article=
 +
|page=
 +
|pages=615-9
 +
|url=https://publications.aap.org/hospitalpediatrics/article/8/10/615/26528/Immediate-Complications-of-Elective-Newborn
 +
|archived=
 +
|quote=
 +
|pubmedID=30262594
 +
|pubmedCID=
 +
|DOI=10.1542/hpeds.2018-0005
 +
|accessdate=2022-01-21
 +
}}</ref>
 +
 +
Litwiller et al. (2018) collected data on 260 circumcisions using the [[Gomco]] clamp. They compared statistics of circumcisions of newborn infants from the normal newborn nursery (NNN) with those from the Newborn Intensive Care Unit (NICU). They found a bleeding rate of 9.6% among neonates from the NNN, but a bleeding rate of 22% among neonates from the NICU.<ref name="litwiller2018">{{REFjournal
 +
|last=Litwiller
 +
|first=Abigail R.
 +
|init=
 +
|author-link=
 +
|last2=Browne
 +
|first2=Courtney
 +
|init2=
 +
|author2-link=
 +
|last3=Haas
 +
|first3=David M.
 +
|init3=
 +
|author3-link=
 +
|etal=no
 +
|title=Circumcision bleeding complications: neonatal intensive care infants compared to those in the normal newborn nursery
 +
|journal=J Matern Fetal Neonatal Med
 +
|location=
 +
|date=2018-06
 +
|volume=31
 +
|issue=11
 +
|article=
 +
|page=
 +
|pages=1513-6
 +
|url=https://www.tandfonline.com/doi/abs/10.1080/14767058.2017.1319931
 +
|archived=
 +
|quote=
 +
|pubmedID=28412847
 +
|pubmedCID=
 +
|DOI=10.1080/14767058.2017.1319931
 +
|accessdate=2022-01-21
 +
}}</ref>
 +
 +
===Deaths===
 +
No one collects statistics on circumcision deaths. The number of boys who die from hemorrhage after [[circumcision]] is unknown. Some have been reported. Some examples are set forth below.
 +
 +
* Julius Katzenstein: 8-days-old, bled to death after circumcision, 14 December 1856, New York, NY, USA.
 +
* Myer Jacob Levy: 8-days-old, bled to death after circumcision, 18 April 1858, New York, NY, USA.
 +
* Michael Julian Baldwin: infant boy, 4-days-old, hemorrhage after circumcision. 21 August 1927, Monroe County, Indiana, USA.
 +
* Boma Oruitemeka: Death by circumcision, severe hemorrhage. 1990, London, England, UK.
 +
* Demetrius Manker bled to death in 1993 after circumcision in Dade County, Florida.<ref>{{REFnews
 +
|title=Baby bleeds to death after circumcision
 +
|url=http://www.cirp.org/news/1993.06.21_death/
 
  |last=
 
  |last=
 
  |first=
 
  |first=
 +
|init=
 
  |author-link=
 
  |author-link=
−
  |publisher=The Free Dictionary
+
|last2=
 +
|init2=
 +
|author2-link=
 +
  |publisher=Miami Herald
 
  |website=
 
  |website=
−
  |date=2004
+
  |date=1993-06-26
−
  |accessdate=2022-01-20
+
|accessdate=2022-01-21
 +
|quote=
 +
}}</ref>
 +
* Hiss et al. (2000) reported the death of an infant from haemorrhage following ritual circumcision in [[Israel]].<ref name="hiss2000">{{REFjournal
 +
|last=Hiss
 +
|first=
 +
|init=J
 +
|author-link=
 +
|last2=horowitz
 +
|first2=
 +
|init2=A
 +
|author2-link=
 +
|last3=Kahana
 +
|first3=
 +
|init3=T
 +
|author3-link=
 +
|etal=no
 +
|title=Fatal haemorrhage following male ritual circumcision
 +
|journal= J Clin Forensic Med
 +
|location=
 +
|date=2000-03
 +
|volume=7
 +
|issue=1
 +
|article=
 +
|page=
 +
|pages=32-4
 +
|url=http://www.cirp.org/library/death/hiss1/
 +
|archived=
 +
|quote=
 +
|pubmedID=15274991
 +
|pubmedCID=
 +
|DOI=10.1054/jcfm.1999.0340
 +
  |accessdate=2022-01-21
 +
}}</ref>
 +
* Ryleigh McWillis died from blood loss after circumcision in British Columbia in 2002.<ref>{{REFdocument
 +
|title=Judgement of Inquiry Into the Death of McWillis[,] Ryleigh Roman Bryan
 +
|url=http://www.circumstitions.com/death-exsang.html
 +
|contribution=
 +
|last=Newell
 +
|first=Chico
 +
|publisher=Office of the Chief Coroner
 
  |format=
 
  |format=
 +
|date=2004-01-19
 +
|accessdate=2022-01-21
 +
}}</ref>
 +
* Ryan Heydari bled to death in Ontario after circumcision in 2015.<ref name="blackwell2015">{{REFnews
 +
|title=Ontario newborn bleeds to death after family doctor persuades parents to get him circumcised
 +
|url=https://nationalpost.com/health/ontario-newborn-bleeds-to-death-after-family-doctor-persuades-parents-to-get-him-circumcised
 +
|last=Blackwell
 +
|first=Tom
 +
|coauthors=
 +
|publisher=National Post
 +
|website=
 +
|date=2015-10-25
 +
|accessdate=2022-01-21
 
  |quote=
 
  |quote=
 
}}</ref>
 
}}</ref>
 +
* "Baby R" died on 24 January 2022 at [https://www.texaschildrens.org/ Texas Children's Hospital] following a brain haemorrhage after [[circumcision]].
 +
 +
{{SEEALSO}}
 +
* [[Bleeding]]
 +
* [[Blood loss danger to infants]]
 +
* [[Death]]
 +
* [[Penile haematoma]]
  
 
{{REF}}
 
{{REF}}
  
−
[[Category:Term]]
+
[[Category:Medical term]]
 
[[Category:Circumcision complication]]
 
[[Category:Circumcision complication]]
 +
[[Category:Circumcision risk]]
 +
 +
[[de:Hämorrhage]]

Latest revision as of 09:07, 25 March 2024

Bleeding wound in the finger
Other names: Hemorrhaging, haemorrhaging

Haemorrhage (bleeding) is [a]n abnormal escape of blood from an artery, a vein, an arteriole, a venule or a capillary network. Haemorrhage may occur into a body cavity or organ, into tissues such as muscles, or externally by way of a wound. Internal haemorrhage often causes a HAEMATOMA. Severe haemorrhage results in dangerous loss of circulating blood volume and there may be insufficient volume to supply the heart muscle and the brain. This is inevitably fatal unless a rapid transfusion of blood is given. Insufficient circulating fluid causes the syndrome of surgical SHOCK for which fluid replacement is urgently needed. This need not be whole blood; an infusion of salt water (saline) can save life.[1]

Haemorrhage after circumcision

Neonatal circumcision is an elective, medically-unnecessary, non-therapeutic amputation of the healthy foreskin that is done only after parents sign a circumcision consent form. It exposes an infant to surgical risks, but does not treat or prevent disease.[2]

Circumcision is an amputative surgical operation that severs arteries and veins as it amputates the foreskin. As with any surgical operation, haemorrhage is an expected complication of surgery.[3][4]

Strong haemorrhage after a circumcision of a boy was the trigger for the Cologne circumcision court judgment in 2012.

The clotting ability of the blood is not tested prior to non-therapeutic infant circumcision as it is thought be unnecessary.[5]

Statistics

Feinberg et al. (2010) collected data on 537 collective Gomco circumcisions. They found 24 bleeds (4.47%). Bleeding was significantly associated with lack of operator experience.[6]

Heras et al. (2018) collected data on 1,115 circumcisions. They found 41 complications (3.9%), all involving haemorrhage. Three patients required sutures.[7]

Litwiller et al. (2018) collected data on 260 circumcisions using the Gomco clamp. They compared statistics of circumcisions of newborn infants from the normal newborn nursery (NNN) with those from the Newborn Intensive Care Unit (NICU). They found a bleeding rate of 9.6% among neonates from the NNN, but a bleeding rate of 22% among neonates from the NICU.[8]

Deaths

No one collects statistics on circumcision deaths. The number of boys who die from hemorrhage after circumcision is unknown. Some have been reported. Some examples are set forth below.

  • Julius Katzenstein: 8-days-old, bled to death after circumcision, 14 December 1856, New York, NY, USA.
  • Myer Jacob Levy: 8-days-old, bled to death after circumcision, 18 April 1858, New York, NY, USA.
  • Michael Julian Baldwin: infant boy, 4-days-old, hemorrhage after circumcision. 21 August 1927, Monroe County, Indiana, USA.
  • Boma Oruitemeka: Death by circumcision, severe hemorrhage. 1990, London, England, UK.
  • Demetrius Manker bled to death in 1993 after circumcision in Dade County, Florida.[9]
  • Hiss et al. (2000) reported the death of an infant from haemorrhage following ritual circumcision in Israel.[10]
  • Ryleigh McWillis died from blood loss after circumcision in British Columbia in 2002.[11]
  • Ryan Heydari bled to death in Ontario after circumcision in 2015.[12]
  • "Baby R" died on 24 January 2022 at Texas Children's Hospital following a brain haemorrhage after circumcision.

See also

References

  1. ↑ REFweb (2004). Haemorrhage, The Free Dictionary. Retrieved 20 January 2022.
  2. ↑ REFjournal Deacon M, Muir G. What is the medical evidence on non-therapeutic child circumcision?. Int J Impot Res. 8 January 2022; PMID. DOI. Retrieved 1 February 2022.
  3. ↑ REFjournal Kaplan GW. Complications of circumcision. Urol Clin N Amer. August 1983; 10(3): 543-9. PMID. Retrieved 20 January 2022.
  4. ↑ REFjournal Williams N, Kapilla L. Complications of circumcision.. Brit J Surg. October 1993; 80(10): 1231-6. PMID. DOI. Retrieved 20 January 2022.
  5. ↑ REFjournal Eroglu E, Sözmen BO, Kayiran SN, et al. Evaluation of coagulation tests before newborn circumcision: is it necessary?. Blood Coagul Fibrinolysis. March 2016; 27(2) PMID. DOI. Retrieved 1 February 2022.
  6. ↑ REFjournal Feinberg, Arthur N., Brust, Rita A., Walker, Travis A.. Bleeding at Circumcision: Patient or Operator Issue?. Clin Pediatr (Phila). August 2010; 49(8): 760-3. PMID. DOI. Retrieved 21 January 2022.
  7. ↑ REFjournal Heras, Andrea, Vallejo, Victoria, Pineda, Marcela L., Jacobs, Allan J., Cohen, Lourdes. Immediate Complications of Elective Newborn Circumcision. Hosp Pediatr. October 2018; 8(10): 615-9. PMID. DOI. Retrieved 21 January 2022.
  8. ↑ REFjournal Litwiller, Abigail R., Browne, Courtney, Haas, David M.. Circumcision bleeding complications: neonatal intensive care infants compared to those in the normal newborn nursery. J Matern Fetal Neonatal Med. June 2018; 31(11): 1513-6. PMID. DOI. Retrieved 21 January 2022.
  9. ↑ REFnews (26 June 1993)."Baby bleeds to death after circumcision", Miami Herald. Retrieved 21 January 2022.
  10. ↑ REFjournal Hiss J, horowitz A, Kahana T. Fatal haemorrhage following male ritual circumcision. J Clin Forensic Med. March 2000; 7(1): 32-4. PMID. DOI. Retrieved 21 January 2022.
  11. ↑ REFdocument Newell, Chico: Judgement of Inquiry Into the Death of McWillis[, Ryleigh Roman Bryan], Office of the Chief Coroner. (19 January 2004). Retrieved 21 January 2022.
  12. ↑ REFnews Blackwell, Tom (25 October 2015)."Ontario newborn bleeds to death after family doctor persuades parents to get him circumcised", National Post. Retrieved 21 January 2022.
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