Difference of delayed post-tonsillectomy bleeding between children and adults

Objective: To analyze the characteristics of post-tonsillectomy bleeding and its management comparing with adults.

Methods: A retrospective chart review of 1489 patients who underwent tonsillectomy in our institution (June 2003-June 2006).

Results: Post-tonsillectomy bleeding rate was 3.1%, 2.5% and 10.8% in younger children (age< or =11 years), older children (12< or =age< or =15 years) and adults (age>15 years), respectively. Although adults showed an unimodal peak time for onset of post-tonsillectomy bleeding, children showed a bimodal peak time. In the younger child group, all of the 28 bleeders had spontaneous hemostasis. However, in the older child group, there was no spontaneous hemostasis. Bleeding was controlled under local anesthesia in 3 patients and 2 patients required general anesthesia for bleeding control. In the adult group, spontaneous cessation of bleeding occurred in 25 patients (60.9%) and hemostasis under local or general anesthesia was performed in 16 (39.1%) patients.

Conclusions: Post-tonsillectomy bleeding occurred more frequently in adults than in children. Spontaneous hemostasis was more prevalent in children than in adults. Post-tonsillectomy bleeding in the younger child group was controlled with close observation alone.