Differential Diagnosis for Vaginal Bleeding Post Hysterectomy
Single Most Likely Diagnosis
- Vaginal stump granulation: This is a common cause of vaginal bleeding after a hysterectomy. The vaginal stump can become inflamed and form granulation tissue, leading to bleeding.
Other Likely Diagnoses
- Infection or abscess: Infection of the vaginal cuff or surrounding tissues can cause bleeding, and an abscess can rupture and bleed.
- Hematoma or seroma: A collection of blood or fluid at the surgical site can become infected or rupture, leading to bleeding.
- Suture line bleeding: Bleeding from the suture line of the vaginal cuff is a possible cause of post-hysterectomy bleeding.
Do Not Miss Diagnoses
- Malignancy: Although rare, vaginal bleeding after a hysterectomy can be a sign of a new or recurrent malignancy, such as vaginal or cervical cancer.
- Ureteral injury: Injury to the ureters during the hysterectomy can cause bleeding, and delayed recognition can lead to severe consequences.
- Vascular injury: Injury to nearby blood vessels can cause significant bleeding and requires prompt attention.
Rare Diagnoses
- Vaginal cuff dehiscence: A rare complication where the vaginal cuff opens up, potentially leading to bleeding and other complications.
- Foreign body reaction: A reaction to a foreign body, such as a retained sponge or instrument, can cause bleeding and other symptoms.
- Arteriovenous malformation: A rare vascular anomaly that can cause bleeding, although this is extremely uncommon in the context of post-hysterectomy bleeding.