Treatment of post tonsillectomy bleeding in Chile

Abstract

Introduction: Tonsillectomy is one of the most frequent surgeries in the pediatric popula- tion. Although it is considered a simple and safe surgery, it has associated risks, the main one being postoperative bleeding. Aim: Evaluate the management of post-tonsillectomy he- morrhage in otorhinolaryngologists practicing in Chile. Material and Method: A descrip- tive cross-sectional study was carried out on the experience and management of post-ton- sillectomy hemorrhage through a survey distributed to active members of the Sociedad Chilena de Otorrinolaringología, Medicina y Cirugía de Cabeza y Cuello (SOCHIORL). Results: Responses were collected from 102 out of 348 active members, of which 97% have presented this complication. The initial measure in a late hemorrhage occurring outside of an otolaryngology unit is referral to the emergency department in 88% of cases. In the emer- gency room, the most frequent management is to administer intravenous tranexamic acid in 80%. In the case of hemorrhage without trace of current bleeding, 68% discharge with early control. If clots are evident in the tonsillar fossa, 72% admit for observation. If there is evidence of active bleeding, 94% admit and perform revision surgery. Conclusion: Results of this study are consistent with international literature. Management in the emergency de- partment is based on the experience of the treating physician and different clinical scenarios. Hospitalization is recommended when clots are observed, revision surgery when evidence of active bleeding and, in patients with no findings at the moment of the evaluation, mana- gement is variable.