[105 cases of post-tonsillectomy hemorrhage revisited]

There is only little systematic evidence about blood-loss and management of cases of post-tonsillectomy hemorrhage.

105 cases of post-tonsillectomy hemorrhage were identified and data as gender, age, time of hemorrhage, amount of blood loss, circumstances of hemorrhage and management of hemorrhage were detailed by chart review.

The typical two points of hemorrhage are the day of surgery and the fifth to eighth postoperative day, the latter as the time of debridement of the fibrin layers. The distribution of gender and age were similar to the cases operated on. In Germany tonsillectomy-patients are kept as inpatients until the fifth to seventh day after sugery to care for pain-management, food-intake and possible hemorrhage. It must be noted that 77 patients experienced hemorrhage after dismission from the ward. Concerning the blood loss, estimated from the hemoglobin-concentration before tonsillectomy and at the time of hemorrhage, we found declines of up to 5 g/dl. Plotted against the time of hemorrhage or against the age of the patient we must state, that blood-loss does not correlate to the time after sugery nor to the age.

We saw severe blood-loss even two weeks after surgery, whereas the events of hemorrhage around the time of debridement of fibrinlayers showed no accumulation of severe outcomes.