Secondary tonsillar hemorrhage: a one year retrospective study in a District General Hospital

Tonsillectomy is one of the most commonly performed surgical procedures. Hemorrhage is its most significant complication. The literature indicates that most concern centres on reactionary rather than secondary hemorrhage. The aims of this study have been to determine the incidence of secondary tonsillar hemorrhage, the influence of patient age and operator experience and the predictive value of a history of infection, bleeding disorders and coagulation studies. A 4% incidence of secondary tonsillar hemorrhage was found, almost half of these having such severe bleeding as to warrant surgical intervention. The following findings also emerged: a) More adults than children suffered secondary hemorrhage. b) Incidence of secondary hemorrhage is independent of operator experience. c) There was a negative history of infection and bleeding disorders. d) Coagulation studies were normal in all cases. Despite improvements in standards and socio-economic and medical advances, secondary tonsillar haemorrhage continues to be a significant risk.