![]() A hemostatic agent or bandage can be used in addition to a pressure dressing to help with hemostasis. Betadine or topical antibiotic agents can be used to clean the wound. When trying to remove a leech from the vagina of a pediatric patient, normal saline flushed through a small feeding catheter has been reported with success.Īfter removing the leech, the wound must be cleaned, and bleeding must be stopped. After the bleeding had stopped, the leech was removed with alligator forceps. The movement of the leech decreased, and the bleeding ceased after 4 hours. Next, the glycerin phenique was placed into the ear. Lidocaine 2%, then hypertonic saline was placed into the ear without decreased movement of the leech. A case report discussed a 24-year-old male with a leech bite in the external ear canal near the tympanic membrane with bleeding from the ear. A 2-year-old was found to have an intrabdominal leech which had perforated her uterus, and it required exploratory laparotomy for removal. Leech removal often requires unique situational removal techniques based on the location of the leech. Caution should be exercised to prevent the jaws from remaining in the wound for the risk of continuous bleeding. Extra caution should be used when removing the leech as to not have reflux of contents back into the bite for risk of infection as well as increased bleeding. Of these, saltwater has been shown to be effective in causing the leech to relax and release. Chemical methods have also been used including cocaine, lidocaine, and topical anesthetic spray. Various methods of leech removal have been utilized including salt, saline, vinegar, turpentine, alcohol, and heat. Initial treatment should include removal of the leech or leeches, controlling blood loss, and preventing exposure to blood-borne pathogens. A rectal exam with a proctoscope may be indicated for a patient presenting with rectal bleeding in the setting of concern for a leech bite. Depending on the age of the patient, this may need to be done under anesthesia. When there is the concern for vaginal leech infestation, a speculum exam is required. If there is a concern for a nasal leech infestation, examination with anterior rhinoscope is not sufficient, and inspection with an endoscope is usually necessary. ![]() Patients may present with recurrent epistaxis if they have a nasal leech infestation.Ī focused physical exam will be required depending on the area of concern. When the leech bite is external, patients' symptoms may include painless bleeding, bruising, itching, burning, irritation, and redness. While most leech bites are external, leeches can attach internally, and patients will present with epistaxis, hematemesis, hemoptysis, vaginal bleeding, hemoptysis, otorrhagia, and rectal bleeding. A detailed history needs to be obtained, including any recent exposure to fresh water.
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