Recurrent post tonsillectomy bleeds: Presentation and characteristics in the paediatric population

Abstract Objective To evaluate the incidence of, features and risk factors for recurrent post tonsillectomy bleeding. Methods Audit of all patients 0–15 years of age undergoing tonsillectomy between 01/2004-12/2014 with selection of those with recurrent bleeding post tonsillectomy for subanalysis. Results Of 5400 single centre tonsillectomies, 234 (4.8%) presented with bleeding and 9 (0.17%) presented with recurrent bleeding. 13 patients in total were treated, 10 surgically. Average patient age: 8.5 years with median time to presentation of the first bleed: 5 days and second bleed: 11 days. There was no association with abnormal coagulation, NSAID usage, severity of the first bleed or surgical technique. The risk of developing a second bleed following treatment for one post tonsillectomy bleeding incident is approximately 1 in 25. Conclusion Recurrent post tonsillectomy bleeds are rare, and cannot be predicted preoperatively. The mainstay of management is surgical cautery, but other interventions are occasionally needed.