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Significance of advanced haemostasis investigation in recurrent, severe post-tonsillectomy bleeding

Published online by Cambridge University Press:  12 May 2011

G Kontorinis  and
B Schwab
G Kontorinis*
Affiliation:
Otorhinolaryngology Department, Hanover Medical University, Germany
B Schwab
Affiliation:
Otorhinolaryngology Department, Hanover Medical University, Germany
*
Address for correspondence: Dr Georgios Kontorinis, Otorhinolaryngology Department, Hanover Medical University, Carl Neuberg Str 1, 30625 Hanover, Germany E-mail: Kontorinis.Georgios@mh-hannover.de
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Abstract

Objective:

To evaluate the significance of advanced post-operative haemostasis investigation in cases of recurrent, severe post-tonsillectomy bleeding.

Materials and methods:

Of the 120 patients treated at our tertiary centre between 2006 and 2010 due to post-tonsillectomy haemorrhage, 22 with recurrent, severe episodes of bleeding underwent further, advanced haemostasis investigation.

Results:

Underlying haemorrhagic disease was not diagnosed in any case. Isolated abnormal clotting factor levels were identified in two patients. Decreased fibrinogen concentration due to dilutional coagulopathy was found in nine cases (40.9 per cent).

Conclusion:

Recurrent, severe post-tonsillectomy haemorrhage is rarely related to undiagnosed haemostatic disorders. Thus, advanced haemostasis studies have little therapeutic relevance. However, repetitive post-tonsillectomy bleeding may be related to decreased fibrinogen levels due to dilutional coagulopathy. Therefore, fibrinogen concentration should be tested, and dilutional coagulopathy treated promptly.

Keywords

HaemorrhagePost-Operative ComplicationsTonsillectomyBlood Coagulation Disorders
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 9 , September 2011 , pp. 952 - 957
Copyright
Copyright © JLO (1984) Limited 2011

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