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Difference of delayed post-tonsillectomy bleeding between children and adults
Dong Wook Kim1, Ja-Won Koo, Soon-Hyun Ahn
1Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Goomi-dong, Bundang-gu, Seongnam 463-707, Republic of Korea.
Insights
Adults experience higher rates of post-tonsillectomy bleeding than children. While children often achieve spontaneous hemostasis, adults may require interventions for bleeding control after tonsillectomy.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Surgical Complications
Background:
- Post-tonsillectomy bleeding is a significant concern.
- Understanding age-related differences in bleeding characteristics is crucial for management.
Purpose of the Study:
- To compare the incidence, timing, and management of post-tonsillectomy bleeding in children and adults.
Main Methods:
- Retrospective chart review of 1489 patients undergoing tonsillectomy.
- Analysis of bleeding rates, onset times, and hemostasis methods across different age groups.
Main Results:
- Bleeding rates were 3.1% (younger children), 2.5% (older children), and 10.8% (adults).
- Children exhibited bimodal bleeding peaks, while adults had a unimodal peak.
- Spontaneous hemostasis was common in younger children but not in older children or adults.
Conclusions:
- Adults have a higher frequency of post-tonsillectomy bleeding compared to children.
- Children, particularly younger ones, show a greater prevalence of spontaneous hemostasis.
- Close observation alone was sufficient for younger children with bleeding.
Objective:
To analyze the characteristics of post-tonsillectomy bleeding and its management comparing with adults.
Methods:
A retrospective chart review of 1489 patients who underwent tonsillectomy in our institution (June 2003-June 2006).
Results:
Post-tonsillectomy bleeding rate was 3.1%, 2.5% and 10.8% in younger children (age< or =11 years), older children (12< or =age< or =15 years) and adults (age>15 years), respectively. Although adults showed an unimodal peak time for onset of post-tonsillectomy bleeding, children showed a bimodal peak time. In the younger child group, all of the 28 bleeders had spontaneous hemostasis. However, in the older child group, there was no spontaneous hemostasis. Bleeding was controlled under local anesthesia in 3 patients and 2 patients required general anesthesia for bleeding control. In the adult group, spontaneous cessation of bleeding occurred in 25 patients (60.9%) and hemostasis under local or general anesthesia was performed in 16 (39.1%) patients.
Conclusions:
Post-tonsillectomy bleeding occurred more frequently in adults than in children. Spontaneous hemostasis was more prevalent in children than in adults. Post-tonsillectomy bleeding in the younger child group was controlled with close observation alone.
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