Is It Safe to Fly After ERCP Surgery with Bleeding Concerns?

If there is bleeding from the wound after an ERCP, is it safe to fly?

Hello, my husband underwent an ERCP 8 days ago (on April 2) due to a gallstone lodged in the bile duct.
After the procedure, he experienced persistent black stools and a drop in blood pressure.
Six days later (on April 7), he returned to the hospital for an examination and it was found that there was a small arterial bleeding at the bile duct site, so he underwent an emergency endoscopic hemostasis.
After starting a liquid diet yesterday, his first bowel movement post-surgery was black, and this morning he had a slightly formed dark stool; therefore, the hospital discharged him.
My husband is scheduled to travel to Japan for business on Thursday.
Is it too risky for him to travel abroad in such a short time? If he experiences black stools again in Japan, can he immediately fly back to Taiwan for treatment? If there is bleeding from the wound, will the cabin pressure on the airplane exacerbate the bleeding situation? Thank you.

Guo Bi Ying, 40~49 year old female. Ask Date: 2018/04/10

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, after undergoing ERCP, postoperative bleeding is generally rare after hemostasis.
However, it depends on whether the patient is prone to bleeding, such as those with chronic kidney failure on dialysis, those using anticoagulants, those on pain medications, or those with hematological disorders.
It is also important to consider whether there is a malignant tumor at the lesion site.
Nonetheless, it is advisable to monitor closely and seek medical attention if any issues arise.
Wishing you safety and health.
Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Gastroenterology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2018/04/10

More Info

Flying after a medical procedure, especially one involving potential bleeding like an Endoscopic Retrograde Cholangiopancreatography (ERCP), requires careful consideration of several factors. Given your husband's recent medical history, including the ERCP and subsequent bleeding complications, it is crucial to weigh the risks before making travel plans.

Firstly, ERCP is a procedure used to diagnose and treat conditions related to the bile ducts, including the removal of gallstones. While many patients recover well after ERCP, complications can arise, such as bleeding, perforation, or pancreatitis. In your husband's case, the need for a second procedure to control bleeding indicates that he has had a more complicated recovery. The fact that he experienced black stools, which can indicate gastrointestinal bleeding, is concerning and should not be taken lightly.

Regarding the safety of flying, there are several considerations:
1. Recent Surgery and Recovery: Your husband is only eight days post-ERCP, and he has already experienced complications. The body needs time to heal, and flying too soon after a procedure can increase the risk of complications. The cabin pressure changes during a flight can affect blood flow and may exacerbate any existing issues, particularly if there is still a risk of bleeding.

2. Monitoring Symptoms: If your husband experiences any signs of bleeding, such as black stools or abdominal pain, while in Japan, it is crucial to seek medical attention immediately. The ability to return to Taiwan quickly will depend on the location and availability of flights, as well as his condition at the time. It is essential to have a plan in place for medical care while abroad.

3. Pressure Changes: The pressure changes in an airplane cabin can potentially affect bleeding. If there is a small artery involved, the changes in pressure could theoretically increase the risk of bleeding or complicate an existing issue. However, this risk varies from person to person and depends on the specific circumstances of your husband's health.

4. Travel Insurance and Medical Facilities: If your husband decides to travel, ensure that he has comprehensive travel insurance that covers medical emergencies. Research the medical facilities available in Japan, particularly those that can address gastrointestinal issues, should he need immediate care.

5. Consulting Healthcare Providers: Before making any travel decisions, it is vital to consult with your husband's healthcare provider. They can assess his current condition, review his medical history, and provide personalized advice on whether it is safe for him to fly. They may also suggest precautions or medications to take during the flight.

In conclusion, while it may be possible for your husband to fly after ERCP, given his recent complications, it is advisable to err on the side of caution. The risks associated with flying shortly after such a procedure, especially with a history of bleeding, warrant thorough discussion with his healthcare team. If there are any doubts about his stability or the potential for complications, postponing the trip until he is fully recovered would be the safest option.

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