Post-tonsillectomy haemorrhage following traditional uvulectomy in an adult patient

Abstract

A 28-year-old IsiPedi-speaking black South Africa male patient presented with recurrent attackes of dry throat, dry cough, sore throat and globus pharyngeus. When asked what he thought was responsible for his symptoms, he said that he suspected an infection of the uvula (lelingwana) and according to \'Pedi\' culture would require surgical removal. After the physical examination, a clinical assessment of chronic tonsillitis and laryngopharyngeal reflux disease was made. The attending surgeon informed him that there was no indication for the removal of the uvula but he would benefit from tonsillectomy and anti-reflux medication. The patient reluctantly agreed to the suggested procedure and a day-case tonsillectomy under general anaesthesia using dry mono-polar diathermy dissection technique was performed. The procedure ws successful with dry tonsillar fossae. When the patient recovered from anaesthesia, he immediately enquired if his uvula was removed but was informed that the tonsils were the only tissues removed as indicated and and consented to. He was discharged and placed on amoxycillin and Myprodol (an analgesic). Later in hte day (19h00), he was rushed back to the casualty department with marked oropharyngeal bleeding and in severe hypovoleamic shock. He was immediately resuscitated and prepared for examination under anaesthesia in the theatre. The main finding was bleeding from a freshly cut uvula but the tonsillar fossae showed no active bleeding.

SA Fam Pract 2005;47(1): 46