Post-tonsillectomy hemorrhage in children with hematological abnormalities

Objective: Tonsillectomy is a common procedure performed in children with the main complication being post-operative hemorrhage. It is uncertain if patients with hematological abnormalities face a higher risk of post-operative hemorrhage. Study design: Retrospective chart review. Setting: Tertiary referral hospital. Patients selected: All patients with a known hematologic disorder as well as children without a hematologic abnormality undergoing tonsillectomy with or without adenoidectomy in the past two years at our institution were included in this study. Main outcome measure: We sought to determine whether children with hematologic disorders are at an increased risk of post-operative hemorrhage after surgery. Results: Four-hundred and sixty-two patients were identified who underwent a tonsillectomy during this time period. Fourteen patients with hematological abnormalities were identified with only one patient suffering a post-tonsillectomy hemorrhage. All patients with abnormal laboratory values prior surgery underwent medical treatment in conjunction with pediatric hematology and did not suffer a post-tonsillectomy hemorrhage. Despite a small study group, the low incidence (1/14) of post-tonsillectomy hemorrhage in patients with hematological abnormalities suggests that these patients may not be at an increased risk, especially if appropriately evaluated and treated pre-operatively. Conclusion: Despite small sample size the results of our study suggest that patients with coagulation disorders may not have an increased risk of post-tonsillectomy hemorrhage when evaluated and corrected pre-operatively.