ISSN: 2476-2490
Authors: Rifai M*, Younes A and Hassan F
Objective: The aim of this study was to highlight the diagnosis and treatment of vascular injury as a rare cause of delayed resistant post-tonsillectomy hemorrhage, and the importance of both treatment modalities (surgical ligation and endovascular embolization). Patients and Methods: This was a retrospective study of 11 patients who experienced delayed resistant post-tonsillectomy hemorrhages (DRPTHs). There were seven males and four females, with their ages ranging between four and sevenyears, and a mean age at presentation of fouryears old. Seven patients were treated using surgical ligation,while five underwent endovascular embolization. Results:All 11cases hadidiopathic vascular abnormalities. Four of the patients developed pseudoaneurysmsof the lingual artery, with onemainly in the linguofacial trunk.The other five patients had direct injuriesto the walls of the lingual (three patients) and facial (two patients) arteries.Bleeding occurredbetween the 11th and 28th days after the tonsillectomies, and successful management included embolization(five patients) and surgery (six patients). Conclusion:DRPTHis extremely rare, and deep suturing of the lower pole of the tonsil is the probable cause of the vascular injury. Early referral for embolization or open surgical exploration and ligation of the bleeding vessel is mandatory.
Keywords:
DRPTH; Pseudoaneurysmof the external Facial and Lingual Arteries; External Carotid Artery Ligation
