Reactionary bleeding following tonsillectomy

Reactionary hemorrhage following tonsillectomy:

Hemorrhage is one of the most important complication following tonsillectomy. Reactionary hemorrhage occurs within the first 24 hours after the surgical procedure. Causes of reactionary hemorrhage is as follows:

1. During surgery the blood pressure of the patient is diminished due to the effects of anesthetic medications. After the effects of the medications wear off, the blood pressure returns to normal causing bleeding from the operated site. This commonly occurs within the first 24 hours after surgery.

2. Slippage of ligatures. During surgical procedure bleeding vessels are ligated. These ligatures can slip due to the repeated swallowing efforts of the patient causing bleeding from the operated site.

Management:

1. Blood grouping and cross matching should be performed.

2. If blood loss is more than 200ml then blood transfusion should be initiated

3. Patient should be shifted to the theater, anesthetized and the bleeding vessels are ligated again.