Pj. Foley et al., MASSIVE BLOOD-LOSS DURING TONSILLECTOMY IN A CHILD WITH CONGENITAL VENOUS MALFORMATION, Paediatric anaesthesia, 7(3), 1997, pp. 243-246
Tonsillectomy and adenoidectomy have become frequently performed outpa
tient procedures and are generally considered to have a low morbidity
profile. Postoperative haemorrhage remains a rare but important compli
cation, while intraoperative uncontrollable bleeding is extremely unco
mmon. A child with congenital vascular malformation of the lip and oro
pharynx undergoing tonsillectomy experienced massive blood loss, subse
quent resuscitation and significant perioperative morbidity including
a prolonged intensive care unit stay. Preoperative/preanaesthetic naso
pharyngoscopic exam and magnetic resonance imaging did not reveal vasc
ular prominence of the tonsils. Preoperative consideration of angiogra
phy or magnetic resonance angiography may be prudent to avoid this pot
entially fatal complication.