A Rare Case of Severe Post Adenoidectomy Secondary Haemorrhage
Tonsillectomy and adenoidectomy are amongst the most common surgeries performed in children. Haemorrhage, after and during these procedures, is a major and known complication. Most commonly, the haemorrhage presents intraoperatively or in the immediate postoperative period and is self-limiting. Howe...
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| Format: | Article |
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JCDR Research and Publications Private Limited
2022-04-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/16207/53480_CE[Ra1]_F(KR)_PF1(SC_SS)_PFA(SC_KM)_PN(KM).pdf |
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| author | Gaurang Singhal Pradeepti Nayak Nishi Sharma |
| author_facet | Gaurang Singhal Pradeepti Nayak Nishi Sharma |
| author_sort | Gaurang Singhal |
| collection | DOAJ |
| description | Tonsillectomy and adenoidectomy are amongst the most common surgeries performed in children. Haemorrhage, after and during these procedures, is a major and known complication. Most commonly, the haemorrhage presents intraoperatively or in the immediate postoperative period and is self-limiting. However, secondary haemorrhage presenting after adenoidectomy where adenoidectomy alone was performed have been reported in very few patients. In this case, a 10-year-old male presented with history of upper airway obstruction including sleep apnoea, adenoid facies, and bilateral moderate conductive hearing loss since four years. He had no co-morbidities, history of bleeding diathesis. The preoperative evaluation of the adenoids (clinically and radiologically) revealed no abnormal vasculature or anatomical variations. Conventional adenoidectomy and bilateral grommet insertion was performed under General Anaesthesia (GA). The postoperative period was entirely uneventful, and the patient was discharged on postoperative day 3. Despite having no risk factors, he presented with profuse posterior epistaxis after conventional adenoidectomy on postoperative day 5. Immediate management was done by posterior nasal packing and intravenous amoxicillin-clavulanate. Definitive treatment was done by re-exploration and debridement of the remnant adenoid tissue using a microdebrider under GA the next day. The patients had no complaints postoperatively or at 6 months follow-up. The rarity of complications makes adenoidectomy a fairly safe procedure. However, despite being uncommon, secondary complications of adenoidectomy should be anticipated by surgeons to avoid dire consequences for the patient. |
| first_indexed | 2024-04-10T16:26:04Z |
| format | Article |
| id | doaj.art-ad1000af8eae4df79d327b95920c6cb5 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-10T16:26:04Z |
| publishDate | 2022-04-01 |
| publisher | JCDR Research and Publications Private Limited |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-ad1000af8eae4df79d327b95920c6cb52023-02-09T04:38:35ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-04-01164MD01MD0310.7860/JCDR/2022/53480.16207A Rare Case of Severe Post Adenoidectomy Secondary HaemorrhageGaurang Singhal0Pradeepti Nayak1Nishi Sharma2Senior Resident, Department of Ear, Nose and Throat, ABVIMS and Dr. RML Hospital, New Delhi, India.Assistant Professor, Department of Ear, Nose and Throat, School of Medical Sciences and Research, Sharda University, Noida, Uttar Pradesh, India.Professor and Head, Department of Ear, Nose and Throat, ABVIMS and Dr. RML Hospital, New Delhi, India.Tonsillectomy and adenoidectomy are amongst the most common surgeries performed in children. Haemorrhage, after and during these procedures, is a major and known complication. Most commonly, the haemorrhage presents intraoperatively or in the immediate postoperative period and is self-limiting. However, secondary haemorrhage presenting after adenoidectomy where adenoidectomy alone was performed have been reported in very few patients. In this case, a 10-year-old male presented with history of upper airway obstruction including sleep apnoea, adenoid facies, and bilateral moderate conductive hearing loss since four years. He had no co-morbidities, history of bleeding diathesis. The preoperative evaluation of the adenoids (clinically and radiologically) revealed no abnormal vasculature or anatomical variations. Conventional adenoidectomy and bilateral grommet insertion was performed under General Anaesthesia (GA). The postoperative period was entirely uneventful, and the patient was discharged on postoperative day 3. Despite having no risk factors, he presented with profuse posterior epistaxis after conventional adenoidectomy on postoperative day 5. Immediate management was done by posterior nasal packing and intravenous amoxicillin-clavulanate. Definitive treatment was done by re-exploration and debridement of the remnant adenoid tissue using a microdebrider under GA the next day. The patients had no complaints postoperatively or at 6 months follow-up. The rarity of complications makes adenoidectomy a fairly safe procedure. However, despite being uncommon, secondary complications of adenoidectomy should be anticipated by surgeons to avoid dire consequences for the patient.https://www.jcdr.net/articles/PDF/16207/53480_CE[Ra1]_F(KR)_PF1(SC_SS)_PFA(SC_KM)_PN(KM).pdfadenoidbleedingcomplicationsdebridement |
| spellingShingle | Gaurang Singhal Pradeepti Nayak Nishi Sharma A Rare Case of Severe Post Adenoidectomy Secondary Haemorrhage Journal of Clinical and Diagnostic Research adenoid bleeding complications debridement |
| title | A Rare Case of Severe Post Adenoidectomy Secondary Haemorrhage |
| title_full | A Rare Case of Severe Post Adenoidectomy Secondary Haemorrhage |
| title_fullStr | A Rare Case of Severe Post Adenoidectomy Secondary Haemorrhage |
| title_full_unstemmed | A Rare Case of Severe Post Adenoidectomy Secondary Haemorrhage |
| title_short | A Rare Case of Severe Post Adenoidectomy Secondary Haemorrhage |
| title_sort | rare case of severe post adenoidectomy secondary haemorrhage |
| topic | adenoid bleeding complications debridement |
| url | https://www.jcdr.net/articles/PDF/16207/53480_CE[Ra1]_F(KR)_PF1(SC_SS)_PFA(SC_KM)_PN(KM).pdf |
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