The Increased Risk of Post-tonsillectomy Hemorrhage in Coagulopathic Children

Abstract

Objective: Tonsillectomy is a routine procedure performed in children with the main complication being postoperative hemorrhage. In coagulopathic patients, does their disease affect management of these children after a tonsillectomy? Whether these patients need more intricate management following a tonsillectomy is important to know to prevent and treat postoperative hemorrhage.

Method: This case series is done through a chart review searching for patients who have undergone a tonsillectomy and have a known coagulopathic disorder. This will include von Willebrand’s disease, Hemophilia A, Hemophilia B, and Factor 8 deficiency.

Results: The results show that these children do not suffer posttonsillectomy hemorrhage at an increased rate over non-coagulopathic patients. These patients should be managed by correction of the Protime and INR to normal ranges prior to procedure. If this is done, these patients are not at an increased risk of postoperative hemorrhage.

Conclusion: While coagulopathic patients are at an increased risk for prolonged hemorrhage, their risk of postoperative hemorrhage is not increased. Correction of INR and Protime decreases their risk of hemorrhage. If a hemorrhage does occur, these patients will require both surgical intervention and specific correction of their coagulopathy.