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Recurrent post tonsillectomy bleeds: Presentation and characteristics in the paediatric population
Graeme van der Meer1, Maayan Gruber2, Murali Mahadevan1
1Department of Paediatric Otorhinolaryngology, Starship Children's Health, Auckland District Health Board, Park Road, Grafton, Auckland, New Zealand.
Summary
Recurrent post tonsillectomy bleeding is rare, occurring in 0.17% of cases. Management primarily involves surgical cautery, as preoperative prediction is not possible.
Area of Science:
- Otolaryngology
- Pediatric Surgery
Background:
- Post-tonsillectomy bleeding is a known complication.
- Understanding the incidence and risk factors for recurrent bleeding is crucial for patient management.
Purpose of the Study:
- To determine the incidence, characteristics, and risk factors associated with recurrent post-tonsillectomy bleeding in children.
- To evaluate the effectiveness of current management strategies.
Main Methods:
- A retrospective audit of 5400 pediatric tonsillectomies performed between 2004 and 2014.
- Subanalysis of patients who experienced recurrent bleeding post-tonsillectomy.
Main Results:
- The incidence of recurrent post-tonsillectomy bleeding was 0.17% (9 out of 5400 patients).
- The average age of affected patients was 8.5 years, with bleeds occurring around 5 and 11 days post-surgery.
- No association was found with coagulation status, NSAID use, bleed severity, or surgical technique.
- The risk of a second bleed after initial treatment is approximately 1 in 25.
Conclusions:
- Recurrent post-tonsillectomy bleeding is a rare event.
- Preoperative prediction of recurrent bleeding is not feasible.
- Surgical cautery is the primary treatment, with other interventions occasionally required.
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