Abstract
Secondary hemorrhage following tonsillectomy, uvulopalatopharyngoplasty (UPPP) and laser midline glossectomy (MLG) is an uncommon complication. Usually, it occures within 10 days after the operations. We experienced three cases of secondary hemorrhage developed more than 10 days after the operations. Case 1 : A 21-year-old man had a tonsillectomy under general anesthesia. 11 hours after the operation, minor bleeding from the bilateral inferior tonsillar fossae occured, which was controlled by the pressing method only. He remained well until the 18th postoperative day when a sudden bleeding from the left inferior tonsillar fossa occured. The hemorrhage was controlled by the pressing method only, but he fell into shock. The patient's life was saved by resusciation. Case 2 : A 53-year-old man had UPPP and MLG under general anesthesia. He remained well until the 17th postoperative day when a sudden bleeding occured, which stopped spontaneously. Tongue base was considerd as the bleeding point. Case 3 : A 30-yearold man had UPPP and MLG under general anesthesia. He remained well until the 12th postoperative day when sudden hemorrhage occured, which arrested spontaneously. Tongue base was considered as the bleeding point. The causes of secondary hemorrhage of the three patients were considered as an increasing of the fibrolytic activity of blood following operations, and insufficient postoperative rest was also considered in case 2 and case 3. Furthermore, postoperative infection might have contributed to the hemorrhage in case 3. In this paper, we emphasize that postoperative 10 day is not a safe day for permission of discharge on tonsillectomy, UPPP and MLG in some cases, and also the importance of thorough implementation of prophylactic measures and adequate response to emergency.
