Post-tonsillectomy hemorrhage

Presentation

• Occurs in 1-6% of tonsillectomies
• Most common on POD 5-7
• Highest incidence in 21-30 year olds
• Lowest in <6 year olds

Work Up

• Physical exam (do NOT remove any clots)
• CBC, T+S or T+C, coags

Management

• ENT consult: Always, rebleeding is common and half of presentations require surgical management
• Airway management (anticipate difficulty and have surgical back up)
• IV, O2, Monitor, NPO, upright position
• Can try direct pressure with tonsillar pack or gauze infused with lido with epi

See Also

Pharyngitis

Sources

Tintinalli, Roberts & Hedges