title: Excessive post-tonsillectomy hemorrhage requiring ligature of the external carotid artery.
abstract: Ligature of the external carotid artery (LECA) is the method of choice in patients with excessive post-tonsillectomy hemorrhage. This retrospective study was undertaken to evaluate the incidence, characteristics and warning signs of excessive post-tonsillectomy hemorrhage.
  
  
  METHODS
  Between January 1988 and December 2000, a total of 25 patients had to be treated by LECA. Tonsillectomy had been previously performed in seven patients at our department (group A) and in 18 patients elsewhere (group B).
  
  
  RESULTS
  LECA was performed in most cases 6 (group A) and 11 days (group B) after tonsillectomy. There was one case with lethal outcome. A total of 12 patients (group B) had been operated by two surgeons.
  
  
  CONCLUSIONS
  Excessive bleeding following tonsillectomy may occur as delayed bleeding, abrupt and require immediate LECA and blood transfusion. Prior recurrent episodes of bleeding can be a warning sign. Anatomical vascular abnormalities have to be considered. Inpatient policy in these underestimated cases was life-saving.
authors.affiliation: Department of Otolaryngology, Plastic Head and Neck Surgery, St. Anna Hospital, Albertus Magnus Str. 33, 47259, Duisburg, Germany. jwindfuhr@aol.com
authors.forename: Jochen P
authors.initials: JP
authors.lastname: Windfuhr
mesh_terms: D000293:Adolescent; D000328:Adult; D002342:Carotid Artery, External / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D005260:Female; D006801:Humans; D015994:Incidence; D008026:Ligation; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D014068:Tonsillectomy / Q000009:adverse effects*; D016896:Treatment Outcome