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Anatomy of Pharynx

Question
16 out of 24
 

Ramu, 15 years of age presents with hemorrhage 5 hours after tonsillectomy. Treatment of choice is: [LQ]



A External gauze packing
B Antibiotics and mouth wash

C Irrigation with saline
D Reopen immediately

Ans. D Reopen immediately Ref. Turner 7 Oth/ed p 366

"Reactionary hemorrhage occurs within a few hours of the operation and may be severe. It may occur after operation and is treated by a return to the theater when the vessle is ligated under anesthesia." -Turner 7 Oth/ed p 366

Also Know

In case of secondary hemorrhage - Generally 20 hemorrhages are self-limiting and bleeding usually stops by the time patient reaches hospital.

Suction of the clot or gargling with diluted hydrogen peroxide is the only treatment required in most cases.

If bleeding recurs, topical epinephrine may be applied to the tonsillar fossa. (Head and Neck Surgery Chris de Souza Vol 2 p 7589)

Return to operation theatre for placing ligature is rarely needed

Remember

• Reactionary hemorrhage are more common in - Adults (> 70 years)

- Males

- Patients with h/o infections

- Infectious mononucleosis

- Recurrent acute tonsilitis

- Scott Brown's 7thled Vol 2 p 1995

Indications for blood transfusion in a case of Tonsillectomy

- End-stage renal disease

- Hypertension In all these patients, if secondary hemorrhages occur - immediately return to

Reduced hemoglobin and hematocrit OT to avoid severe complications

Anatomy of Pharynx Flashcard List

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