Clin Exp Otorhinolaryngol.  2010 Mar;3(1):56-58.

Spontaneous Tonsillar Hemorrhage and Post-Tonsillectomy Hemorrhage

• Kim YS
• Hong SJ
• Choi J
• Lee SH
• Kwon SY
• Choi JH

Abstract

Spontaneous tonsillar hemorrhage from infectious causes is extremely rare and post-tonsillectomy hemorrhage, although also relatively rare, is an unavoidable complication of the procedure. Hemorrhage in association with tonsillitis or tonsillectomy is potentially dangerous and can be life threatening. We report here the presentation and management of a 42-yr-old man with severe spontaneous hemorrhage from infected tonsils and post-tonsillectomy hemorrhage. We suggest that if attempts to control the bleeding are not successful or if severe spontaneous tonsillar hemorrhage occurs repeatedly or a malignancy is suspected, tonsillectomy and close postoperative follow up is recommended.

Keyword

Hemorrhage; Palatine tonsil; Tonsillectomy

MeSH Terms

Hemorrhage
Palatine Tonsil
Tonsillectomy
Tonsillitis

Figure

• 

  Fig. 1 Intraoral photograph showing bleeding from the lower pole of the right tonsil (arrow).

• 

  Fig. 2 Section of tonsil showing prominent subepithelial blood vessels beneath the covering stratified squamous epithelium and the underlying lymphoid germinal center with reactive hyperplasia. There was no other primary pathologic vascular abnormality visible (H&E, ×100).

Reference

1. Shatz A. Spontaneous tonsillar bleeding; secondary to acute tonsillitis in children. Int J Pediatr Otorhinolaryngol. 1993; 3. 26(2):181–184. PMID: 8444561.

2. Griffies WS, Wotowic PW, Wildes TO. Spontaneous tonsillar hemorrhage. Laryngoscope. 1988; 4. 98(4):365–368. PMID: 3352432.

3. Levy S, Brodsky L, Stanievich J. Hemorrhagic tonsillitis. Laryngoscope. 1989; 1. 99(1):15–18. PMID: 2909817.

4. John DG, Thomas PL, Semeraro D. Tonsillar haemorrhage and measles. J Laryngol Otol. 1988; 1. 102(1):64–66. PMID: 3343568.

5. Kumra V, Vastola AP, Keiserman S, Lucente FE. Spontaneous tonsillar hemorrhage. Otolaryngol Head Neck Surg. 2001; 1. 124(1):51–52. PMID: 11228452.

6. Dawlatly EE, Satti MB, Bohliga LA. Spontaneous tonsillar hemorrhage: an underdiagnosed condition. J Otolaryngol. 1998; 10. 27(5):270–274. PMID: 9800625.