bleeding from mouth and nose

[kimmyajo]

my Mother had lung cancer, stage 3B  (16 months) and one lung collasped.  They did surgery, scraping the chest wall and using talc to attach lung back to chest wall.  Surgery went well, she came home 4 days later.  We all were going on a cruise 6 days after she came home, we checked into our cabin and she laid down to rest, she coughed, spit it out, it was blood (never had happened before) and she then started vomiting blood, after 3 times of that, blood literally started pumping out of her mouth and nose, within 5 minutes she was dead.  I cannot understand what made her bleed like this?  It haunts me, it was so fast and unexpected.  Don't get me wrong, I thank God if she had to go it was fast, but what happened to cause that?  An autopsy was done and they found cirrohsis of the liver-severe, which no doctor ever mentioned before and we all know how much blood work is done to cancer patients.  Prior to death she had no bloody cough, no bloody vomit, no bloody stool, no symptoms or liver disease.  Does anyone know why might have happened?

[kimmyajo]

Thank you, I am trying to be positive.  The M.E. told me the only reason it will be 3 months is because the lab stays so backed up.  I did read up on the information you gave me and it does sound like a it may have been a ruptured vein in the esophagus, just the way it happened and how the blood came.  She had also been on heparin for the 10 days she was hospitalized for the collasped lung which may have contributed to the deadly bleed.  Again, I thank you for your time, it helps to see your opinion and comforts me to know that it wasn't painful for her.

[HeinrikMD]

Hi,

Three months seems pretty long, the longest things to prepare in my mind would be infectious disease cultures (in which you have to wait for the organism to grow), I wonder if this even likely to be the main culprit.

I only hope that whatever the findings would be, would mean closure for you. By the end of three months you may have passed the grieving period, if the report comes out with unexpected findings – this may open up some old wounds.

Stay positive.

[kimmyajo]

Thank you so much for your answer.  I did speak with the pathologist but he told me the cause of death was "pending" as he did some histology and other tissue samples and it would be about 3 months before he knew for sure.  It is just so hard waiting.  I keep wondering if it was something I should have seen symptoms of.  I am very glad I was with her and she was not alone, as haunting as it was for me, I know she would have been so scared and lonely without me there, even the doctor said it was so fast they couldn't have saved her if she was in a hospital.  Anyway, thank you very much for your time.

[HeinrikMD]

Hi,

My condolences on your loss. I think the best person to answer is the pathologist who performed the post-mortem examination.
If one may hazard a guess, I would consider the following scenario:
Liver cirrhosis may be present in fairly asymptomatic patients because of the capacity of the residual liver to maintain function unless it is challenged.
Chances are, she was already bleeding before the coughing fits. She could be unknowingly swallowing some blood, but more likely she also bled from the esophagus (this is common in liver cirrhosis). The liver produces elements that help control bleeding – a critical bleed may consume what the liver can produce, and if it does occur – bleeding will be continuous.
It is indeed an awful experience to attend to a loved one bleeding to death. You may continually ask questions to yourself during some dark hours, if you should have done things differently. Perhaps the important thing was that you were there