Pitfalls of operative management of secondary post-tonsillectomy haemorrhage--a case report

B-ENT. 2013;9(4):335-7.

Abstract

Introduction: The authors present a potential complication associated with the surgical management of post-tonsillectomy haemorrhage using absorbable cellulose haemostatic dressings. The article discusses the deficiencies of our current understanding of how best to manage this common and potentially life-threatening ENT emergency.

Case report: A 40-year-old man presented to Accident-and-Emergency with a post-tonsillectomy haemorrhage on the 7th postoperative day. The bleeding was managed surgically, with suturing of the faucial pillars incorporating a piece of Surgicel into the closure. Two days later the patient experienced an episode of partial airway obstruction, due to a piece of dislodged haemostatic material, owing to failure of the closure. The techniques used in the operative management of post-tonsillectomy bleeding are not formally evaluated or discussed in the current literature, and in some cases are unreliable or even potentially hazardous. Further discussion, research, and formulation of a more stepwise approach would be of considerable benefit.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cellulose, Oxidized / administration & dosage
  • Follow-Up Studies
  • Hemostasis, Surgical / methods*
  • Humans
  • Male
  • Polyglactin 910 / administration & dosage
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / surgery*
  • Tonsillectomy / adverse effects*

Substances

  • Cellulose, Oxidized
  • Polyglactin 910
  • Surgicel