Management of secondary hemorrhage following pediatric adenotonsillectomy

Danesh B. Irani, Robert G. Berkowitz*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    27 Citations (Scopus)


    A retrospective study was performed of all patients requiring admission to the Royal Children's Hospital, Melbourne over a 12 year period with secondary haemorrhage following adenotonsillectomy, to determine what percentage of these children received blood transfusions or were returned to the operating room to secure hemostasis, and to identify factors predictive of the need for major intervention. There were 163 children who presented from 2 to 15 days following surgery. Initial management in all cases was establishment of intravenous access, and 151 received intravenous or oral antibiotics. One hundred and forty one were managed without the need for major intervention (87%), including five who had silver nitrate cautery to the tonsillar fossae. Major intervention was required in 22 cases (13%): 5 patients were returned to the operating room for hemostasis; 15 received blood transfusions and 2 underwent both. All surgery was required within 12 h of admission and all blood transfusions within 24 h. The highest rates of major intervention were in those with fresh bleeding at the time of presentation (38%) and hemoglobin levels less than 100 g/l (36%). For those requiring admission with secondary haemorrhage, a period of observation of 24 h would probably be adequate in the majority of cases to identify those children who will require major intervention by surgery or transfusion.

    Original languageEnglish
    Pages (from-to)115-124
    Number of pages10
    JournalInternational Journal of Pediatric Otorhinolaryngology
    Issue number2-3
    Publication statusPublished - 20 Jun 1997


    • Adenotonsillectomy
    • Secondary haemorrhage
    • Tonsillectomy


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