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[Hemorrhagic complications after tonsillectomy and adenoidectomy. Experiences with 7,743 operations in 14 years]
Insights
Postoperative bleeding after tonsillectomy and adenoidectomy occurs in 1.25% of pediatric patients. Most bleeding events happen around the fifth day, indicating current screening and observation methods are insufficient for prevention.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Hemostasis
Abstract:
During 14 years the department of otolaryngology at Leoben performed 7743 tonsillectomies and/or adenoidectomies in children in cooperation with the department of pediatrics. 97 patients were treated for postoperative bleeding = 1.25%; one child died as a consequence of severe bleeding. The analysis of age, timing and severity of the bleeding includes 15 additional children whose surgery had been performed elsewhere. Only 7 of the 112 bleeding episodes occurred during the first 24 hours after surgery. Most cases (18) occurred on the fifth postoperative day. The latest episode occurred on the 20th day after tonsillectomy. Because of severe blood loss, 18 patients received a blood transfusion. Despite pre- and postoperative coagulation tests no patient suffering from a coagulation disorder was identified. Neither the coagulation screening nor a 48 to 72 hour postoperative in hospital observation could prevent the risk of postoperative bleeding.