Recurrent post tonsillectomy bleeds: Presentation and characteristics in the paediatric population

Publication date: Available online 2 May 2017
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Graeme van der Meer, Maayan Gruber, Murali Mahadevan
ObjectiveTo evaluate the incidence of, features and risk factors for recurrent post tonsillectomy bleeding.MethodsAudit of all patients 0-15 years of age undergoing tonsillectomy between 01/2004-12/2014 with selection of those with recurrent bleeding post tonsillectomy for subanalysis.ResultsOf 5400 single centre tonsillectomies, 234 (4.8%) presented with bleeding and 9 (0.17%) presented with recurrent bleeding. 13 patients in total were treated, 10 surgically. Average patient age: 8.5 years with median time to presentation of the first bleed: 5 days and second bleed: 11 days. There was no association with abnormal coagulation, NSAID usage, severity of the first bleed or surgical technique. The risk of developing a second bleed following treatment for one post tonsillectomy bleeding incident is approximately 1 in 25.ConclusionRecurrent post tonsillectomy bleeds are rare, and cannot be predicted preoperatively. The mainstay of management is surgical cautery, but other interventions are occasionally needed.



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