Hemorrhage after Tonsillectomy in Pediatric Patients Living in Rural Regions

Abstract

Objective: Tonsillectomy is the most commonly performed operation in otolaryngological clinics. There are many possible complications. We explored the incidence of hemorrhage, which is the most important complication because it can result in death. Method:We included 83 pediatric patients who underwent tonsillectomies in a second-level state hospital. We retrospectively reviewed patients who developed postoperative bleeding.Results: Forty-five patients were male and thirty-eight were female (mean age 8.2 years). Bleeding after tonsillectomy developed in five patients. All bleeding was secondary (after the first 24 h). Four cases developed in summer and one in winter. All hemorrhages were chemically cauterized using a silver nitrate rod under local anesthesia. No additional interventions were required. Conclusion:Post-tonsillectomy hemorrhage in a rural area was caused by extreme heat. Thus, tonsillectomy is best performed in spring and autumn if possible.

Correlation between clinical grading of adenoid or tonsil hypertrophy and adenoid or tonsil volume post adenotonsillectomy: a prospective cohort study

“…Having knowledge of the adenoid/tonsil size/volume would assist the surgeon to predict the extent of surgery to avoid excessive, partial or suboptimal surgery leaving behind remnants with PTH as consequences for both. 21,34 Primary PTH usually occurs within the first 6 to 8 hrs which constitutes over 80% of primary PTH and is more dangerous due to the risk of aspiration, laryngospasm and low amount continuous bleeding/swallowing, usually not immediately evident as patients are yet to recover fully from GA, with a subsequent circulatory collapse. [35][36][37] Furthermore, much of the mortality in tonsillectomy is directly/indirectly associated with primary PTH Windfuhr et al in a metaanalysis cited several lethal outcomes including a case of fatal hemorrhage from adenoidectomy in a 5-year old female in an attempt to remove adenoidal remnant secondary to a suspected nasopharyngeal arterial anomaly or over curettage despite 10 units of blood transfusion.…”