title: Significance of advanced haemostasis investigation in recurrent, severe post-tonsillectomy bleeding.
abstract: OBJECTIVE
  To evaluate the significance of advanced post-operative haemostasis investigation in cases of recurrent, severe post-tonsillectomy bleeding.
  
  
  METHODS
  Of the 120 patients treated at our tertiary centre between 2006 and 2010 due to post-tonsillectomy haemorrhage, 22 with recurrent, severe episodes of bleeding underwent further, advanced haemostasis investigation.
  
  
  RESULTS
  Underlying haemorrhagic disease was not diagnosed in any case. Isolated abnormal clotting factor levels were identified in two patients. Decreased fibrinogen concentration due to dilutional coagulopathy was found in nine cases (40.9 per cent).
  
  
  CONCLUSIONS
  Recurrent, severe post-tonsillectomy haemorrhage is rarely related to undiagnosed haemostatic disorders. Thus, advanced haemostasis studies have little therapeutic relevance. However, repetitive post-tonsillectomy bleeding may be related to decreased fibrinogen levels due to dilutional coagulopathy. Therefore, fibrinogen concentration should be tested, and dilutional coagulopathy treated promptly.
authors: Otorhinolaryngology Department, Hanover Medical University, Germany. Kontorinis.Georgios@mh-hannover.de
authors: G
authors: G
authors: Kontorinis
authors: B
authors: B
authors: Schwab
mesh_terms: D000293:Adolescent; D000328:Adult; D001778:Blood Coagulation Disorders / Q000175:diagnosis* / Q000453:epidemiology; D001780:Blood Coagulation Tests; D002648:Child; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012008:Recurrence; D012907:Smoking / Q000009:adverse effects; D014068:Tonsillectomy / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D005340:Fibrinogen