Prolonged Bleeding after a Single Leech Application in Pediatric Hand Surgery

This case report documents an instance of profound, life-threatening bleeding following a single medicinal leech application during pediatric microsurgery, which the authors describe as unprecedented in the literature. For hirudotherapy, this finding is directly relevant as it illustrates a severe hemorrhagic complication associated with leech use, highlighting that even a single application can result in clinically significant ongoing bleeding in certain patients. It underscores the importance of close surveillance and preparedness for bleeding complications when leeches are applied, particularly in pediatric populations. However, as a single case report, this observation cannot establish incidence rates, identify patient-specific risk factors, or elucidate underlying mechanisms. It serves as a clinical caution regarding the potential for rare but serious adverse events in leech therapy, rather than as systematic or quantitative evidence of risk.