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Severe hoarseness, vomiting blood – anesthesia complication?

03/13/2006

Question:

I had laprascopic surgery 5 weeks ago for a hernia. Since that time, I had some minor nausea with severe hoarseness in my voice with a sore throat. The surgery itself went fine. The voice hoarseness and sore throat is still there and now I have vomited a small amount of blood 1 time. I had not eaten that day and the blood was pink with saliva only. Could this be something caused from the anesthesia during surgery? I am not taking any medications at this time. Thank you for any help.

Answer:

A sore throat after general anesthesia is not uncommon, occurring about 20-30% of the time. In most cases it is mild, and gets better without treatment over a couple of days.

Similarly, nausea after general anesthesia is quite common, especially if you are young, female, have had postoperative nausea or motion sickness before, a long anesthetic, and if you have had certain types of surgery, such as breast operations, eye or ear procedures, shoulder operations and others.

It is certainly unusual that you would have your sore throat, or nausea, 5 weeks after the anesthetic. Coughing or vomiting blood is quite an alarming symptom so I’m sure you’re worried. It doesn’t necessarily represent something nasty but should definitely be investigated.

Recent studies have shown that even when the intubation goes very smoothly, the passage of the breathing tube into the larynx (voice-box) and through the vocal cords often causes minor trauma – bruising. In rare cases, the small cartilages of the larynx can be significantly damaged, and this can take quite a long time to recover. The main symptom in this case is hoarseness. More serious injury to the voice box, or to the nerves that supply it, is also possible.

Very rarely, the sore throat can be a sign of something even more ominous – a tear in the lining of the throat that if extensive can lead to severe infection, called mediastinitis. This can happen if the intubation (insertion of breathing tube) is traumatic for some reason, and if the lining of the throat is abnormally thin (e.g. elderly people, or those taking steroids) but this will usually happen over the few days immediately after the operation, not 5 weeks later.

It is possible that your larynx was injured during the intubation or the course of the anesthetic. For this reason you should call your doctor and ask for a referral to an ENT (Ear, Nose and Throat) doctor who can do a thorough examination of your throat. It would also be a good idea if possible to make contact with your anesthesiologist. He or she will be keen to know that something has happened that might be related to anesthesia care and I imagine will be interested in helping you get diagnosed and appropriately treated.

For more information:

Go to the Anesthesia health topic.