Case Presentation
A twenty-six years P5L5 lactating female, status post total abdominal hysterectomy (TAH) with bilateral salphingo-oohorectomy (BSO) on her 4th post-operative day presented to emergency with complaints of paleness, documented fever of 103F without chills and rigors for 2 days and bleeding from the surgical drainage site since 3rd postoperative day. She was referred from another setting in the wake of an abrupt fall in hemoglobin percentage likely due to massive bleeding from the drainage site due to slippage of ligature and self-pullout of the drain. No other significant history was noted at the time of admission. On examination, she appeared ill but was conscious with well orientation to time, place and person and 15/15 on the Glasgow Coma scale (GCS). Findings included pallor in the conjunctiva and pale-looking skin, tachycardia with 128 bpm, regular, tachypnea with 28 breaths/min, and a temperature of 100 F. Her abdominal examination revealed a non-distended abdomen with a midline vertical incision on the lower abdomen, clean without pus or inflammation, with a drain site that was soggy and tender, and without any significant CNS, CVS or respiratory system findings. [Fig.1]. She had undergone elective TAH with BSO for a single hypoechoic lesion of 32.88mm at the left adnexa [Fig.2,3]. At ER, she was managed with IV antibiotics, antipyretics, PPI and one pint of whole blood transfusion, the blood and urine samples were sent for further investigations. The detailed compared laboratory findings of the patient at the time of admission to that before the surgery is tabulated in