title: Our experience with pre-operative haemostatic assessment of paediatric patients undergoing adenotonsillectomy at Federal Medical Centre, Makurdi.
abstract: BACKGROUND
  In 2-4% of all patients requiring adenoidectomy, tonsillectomy or adenotonsillectomy, pre-operative screening tests for coagulation disorders are indicated to detect surgical bleeding complications. However, because of cost effect on the patients, the usefulness of these tests is being challenged. We therefore highlight our experience in paediatric patients undergoing adenoidectomy, tonsillectomy or both in our centre.
  
  
  METHODS
  This is a 3½-year analysis of the data of 165 paediatric patients who had adenoidectomy, tonsillectomy or both over the study period. The data collected included age, sex, procedure done and detailed clinical bleeding history.
  
  
  RESULTS
  A total of 165 children had either adenoidectomy or tonsillectomy, or both. There were 76 males and 89 females giving a male to female ratio of 1:1.2. Their ages ranged from 10 months to 18 years. Eighty-five (51.5%) patients had adenotonsillectomy, 48 (29.1%) and 32 (19.4%) had only tonsillectomies and adenoidectomies, respectively. Only 11 (6.7%) families volunteered the history of either prolonged bleeding with minor injury on the skin or occasional slight nose bleeding. Six (3.6%) patients including 3 of the children with positive family history had posttonsillectomy bleed, out of which 4 (66.7%) were moderate whereas the remaining 2 (33.3%) were severe bleeding, which was not statistically significant (P = 0.041). The two cases of severe bleeding had fresh whole blood transfused whereas the rest that had no bleeding issues were discharged home 48 h postoperatively.
  
  
  CONCLUSIONS
  Our experience in this study suggests that detailed bleeding history is necessary as well as pre-operative haemostatic assessment, if available and affordable for paediatric patients undergoing adenotonsillectomy.
authors.affiliation: Department of Surgery, College of Health Sciences, Benue State University, Makurdi, Nigeria.
authors.forename: Amali
authors.initials: A
authors.lastname: Adekwu
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, College of Medical Sciences, University of Jos, Jos, Nigeria.
authors.forename: Agida Samuel
authors.initials: AS
authors.lastname: Adoga
authors.affiliation: Department of Surgery, Benue State University Teaching Hospital, Makurdi, Nigeria.
authors.forename: Terna Ambrose
authors.initials: TA
authors.lastname: Gav
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006403:Hematologic Tests; D020141:Hemostatic Disorders / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D008297:Male; D009549:Nigeria; D019106:Postoperative Hemorrhage / Q000209:etiology*; D011300:Preoperative Care; D012189:Retrospective Studies; D018570:Risk Assessment; D014068:Tonsillectomy / Q000009:adverse effects*