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Vakul Aren
Vakul Aren, Doctor
Category: Cardiology
Satisfied Customers: 3825
Experience:  MBBS,DTM&H,34 years of experience
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I feel about 6 weeks ago in the mountains on a slippery rock

Customer Question

Hi. I feel about 6 weeks ago in the mountains on a slippery rock in a stream. It was a tough fall. The whole side of my leg was absolutely black. I have a large hematoma the size of my fist on the outside portion of my right leg. My PCP feels that I need to be referred to someone to drain it. I cannot lie on that side at all. What type of specialist will do this?
JA: What seems to make the symptoms worse or better? Have you noticed any swelling?
Customer: Yes. It’s very swollen. The dark blood has finally subsided and I had an ultrasound performed on it yesterday. The radiologist says that he could not see the entire field because it is so large.
JA: Anything else in your medical history you think the doctor should know?
Customer: I am scheduled to have catheter ablation for AFib Sept. 15-16th of next month. I begin an anticoagulant very soon.
Submitted: 7 months ago.
Category: Cardiology
Expert:  dansheibley replied 7 months ago.

Hello. You should be referred to an interventional radiologist who can drain this collection safely under either ultrasound or ct guidance. We watch our needles go into collections and masses in real time and can be careful to avoid any important structures. Depending on how well it drains, either you'd leave with just a bandaid on your leg or a small drain that stays in for 1 to only a few weeks. This is an outpatient procedure your primary care physician can order for you.

Expert:  dansheibley replied 7 months ago.

Definitely get this taken care of before you begin an anticoagulant. Did I provide you a satisfactory answer?

Customer: replied 7 months ago.
Thank you. You thoroughly answered my question.
Expert:  dansheibley replied 7 months ago.

Glad to have helped

Customer: replied 6 months ago.
Expert:  Vakul Aren replied 6 months ago.

Hello,I am Dr. Aren and I will help with your query.I agree with the first expert in that the collection should be drained,this can be done by an expert general surgeon or by aninterventional radiologist,but should be done under strict aseptic conditions/in a operation theatre.A small drain will probably be left in the dependent part of the wound to enable full emptying of the fluid/blood from the cavity subsequent to the procedure.The use of a compression bandage after the draining will help prevent recollection .The fluid/blood drained should be sent for culture and sensitivity to identify any infection,the report will help identify the best antibiotics after you get the report.No anticoagulant should be started till this wound has healed completely,you may need to delay your procedure till such healing has occurred.