Post tonsillectomy bleeding a review of 500 cases

ABSTRACT

To study the incidence of bleeding following tonsillectomy, its relation to age and sex, and the effect of different hemostatic techniques on the occurrence of bleeding. Five hundred tonsillectomies were performed in the ENT department at Al Zahrawi Teaching Hospital in Baghdad, over seven years. The incidence of post tonsillectomy bleeding and the effect of age, sex, method of hemostasis and time of bleeding were studied. The incidence of major post-tonsillectomy bleeding was 1.4%, and there was an increased incidence in patients over the age of twenty. Secondary bleeding was more common in females. Eighty percent of reactionary bleeding happened in the first six hours after surgery, and most of secondary bleeding occurred toward the end of the first week. We noticed increased severity of pain prior to secondary bleeding in a number of cases. Tonsillectomy is the most commonly performed surgical procedure. Careful assessment of patients must be performed, especially in females older than twenty in whom the frequency of bleeding is higher, possibly due to a hormonal effect. The increase in the intensity of pain a few hours prior to the onset of bleeding may give a warning to start therapy that may abort the bleeding