Recurrent haemorrhage following chalazion incision and curettage in a patient with chronic kidney disease

Abstract

Chalazia are commonly seen as eyelid lesions caused by inflammation of the meibomian glands. Most chalazia resolve spontaneously or with medical treatment. Incision and curettage are required for chalazia that persist even after medical management. Even this simple outpatient department (OPD) procedure, if not performed with utmost caution and considering all the systemic factors, can have dire consequences. We present a case report of a patient with known hypertension and stage five chronic kidney disease (CKD) on maintenance hemodialysis presented with multiple chalazia on the lower lids of both eyes. He underwent an uneventful chalazion incision and curettage for both the eyes three days apart. Hemodialysis was done five days later, after which the patient had profuse bleeding from the wound site. Bleeding was temporarily controlled with a tight pressure patch, but the patient continued to have intermittent bleeding the next day. All hematological parameters were within normal limits except for slightly decreased hemoglobin, and the patient was treated systemically. Knowledge and treatment of the factors impairing hemostasis in patients with CKD help reduce the risk of perioperative bleeding. It is essential to be vigilant in such a situation to manage any untoward complications.