Advances in Medical Research
Open Access
ISSN: 2564-8942
+44 1478 350008
ISSN: 2564-8942
+44 1478 350008
Dema Motter
United Kingdom
Scientific Tracks Abstracts: Advances in Medical Research
Introduction: Spontaneous tonsillar haemorrhage: rare but potentially life-threatening non-iatrogenic condition. It is defined as continuous bleeding for more than one hour, or more than 250ml of blood loss regardless of the duration of bleeding1. Bacterial tonsillitis is the most common cause of spontaneous tonsillar haemorrhage, and accounts for 1.1% of cases2. Spontaneous haemorrhagic tonsillitis has been reported in 55 patients in the worldwide literature to date3 Conservative management includes direct pressure with adrenalinesoaked gauze, use of silver nitrate and Hydrogen Peroxide gargles. If bleeding fails to cease conservatively, surgical intervention is required. Case presentation: 22-year-old British male, previously healthy, presented to the Ear, Nose and Throat emergency service at the Royal London Hospital with one-hour history of spontaneous tonsillar bleeding. Two days prior to his presentation, he was seen by his local General Practitioner and was diagnosed with acute tonsillitis and was commenced on oral antibiotics. No significant surgical, medical or social history was noted. On examination, there was active bleeding from the inferior pole of the right tonsil, which was arrested in the emergency department using adrenaline-soaked gauze. Haemoglobin level at presentation was 141 g/L. He was admitted to the hospital for observation. No further bleeding overnight, and the patient significantly improved. He was discharged home the next day. Conclusion: Spontaneous tonsillar haemorrhage is a surgical emergency that could be fatal if not managed appropriately. If the bleeding does not cease conservatively, bilateral tonsillectomy might be required as soon as possible. It is important to identify the cause of tonsillar bleed. The majority are due to acute tonsillitis, but other causes such as peritonsillar abscess, mononucleosis and tonsillar cancer have been reported. Spontaneous tonsillar haemorrhage will need to be investigated accordingly. 1. Vlastarakos, P.V. and Iacovou, E. (2013). Spontaneous tonsillar hemorrhage managed with emergency tonsillectomy in a 21-yearold man: a case report. Journal of Medical Case Reports, [online] 7, p.192. 2. Griffies, W.S., Wotowic, P.W. and Wildes, T.O. (1988). Spontaneous tonsillar hemorrhage. The Laryngoscope, [online] 98(4), pp.365â??368. 3. Salem A, Healy S, Pau H. Management of spontaneous tonsillar bleeding: review. J Laryngol Otol. 2010;124:470â??473. doi: 10.1017/S0022215109992696. [PubMed]