[Arterial aneurysms as cause of gushing post-tonsillectomy hemorrhage].
Aneurysms of the external carotid artery can be causally for threatening late hemorrhage secondary to tonsillectomy. On the bases of typical, extended and finally dramatic bleeding course in a child the "clinical look" and the sensitivity should be raised for this bleeding cause. Characteristic after apparently inconspicuous post-operative first phase is late signal bleeding with little loss of blood which are replaced after following intervals free of bleeding from bleeding as flood with massive loss of blood. Then vessel-imaging (Angio-MRI or CT) is urgently indicated. By confirmation of the suspicion diagnosis the interventional angiography is the therapy of the choice, although after successful embolisation a fine-meshed postcontrol is necessary, because therapy failures are possible how the described case points. The highest security offers the surgical exploration with aimed vessel stopping.
Hoff
M
M
Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie Otto Körner, Universität Rostock. michael.hoff@medizin.uni-rostock.de
Graumüller
S
S
Pau
H W
HW
D000783:Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D000792:Angiography; D002340:Carotid Artery Diseases / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D002342:Carotid Artery, External / Q000000981:diagnostic imaging; D002648:Child; D004621:Embolization, Therapeutic; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D012008:Recurrence; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014068:Tonsillectomy / Q000009:adverse effects*; D016896:Treatment Outcome