Von Willebrand disease as cause of unanticipated bleeding following adeno-tonsillectomy

Von Willebrand disease (vWD) is a frequent autosomal bleeding disorder. We report two unsuspected patients over 6 years of age with this disease opera ted by tonsillectomy and adenoidectomy (T&A) at our Department. Preoperativ e hematologic work-up (with activated partial thromboplastic time, prothrom bin time, fibrinogen, and platelet count) was normal. Both patients had und ergone previous adenoidectomy without complications. In both cases, profuse bleeding was noted in the immediate postoperative period. The therapeutic measures in these situations are discussed and a review of the current lite rature concerning preoperative hematologic evaluation of T&A is included. ( C) 1999 Elsevier Science Ireland Ltd. All rights reserved.