HEMORRHAGE following tonsillectomy or adenotonsillectomy is a serious postoperative complication which remains a possibility, even with today's improved measures of surgical and medical management. Differentiation into primary and secondary bleeding is made on the basis of the interval elapsing between surgery and hemorrhage. Primary hemorrhage usually is noted within the first 24 hours, and is attributable to surgical technique or poor clot formation. There is some evidence that the operative procedure itself may cause greater loss of blood than is generally suspected. Spoerel and co-workers found that 18% of postadenotonsillectomy patients lost more than 10% of their blood volume.1
Secondary hemorrhage is defined as bleeding from causes unrelated to the primary surgical procedure. It usually becomes manifest about five to seven days postoperatively when the patient has been at home and gradually increasing his activity for several days. This sudden untoward event can understandably produce serious concern in the
ELSEN J. Post-Tonsillectomy Effects of a Medicated Chewing Troche. Arch Otolaryngol. 1965;82(1):78–80. doi:10.1001/archotol.1965.00760010080018
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