L'urgence hémorragique postopératoire : algorithme de gestion

Tonsillectomy is commonly performed and is sometimes endowed with complications like post-tonsillectomy bleeding (PTB). It can either be primary, occurring during the first day after surgery, most frequently within the first 6 h following the operation, or secondary, usually between Day 5 and Day 15. The latter are more frequent than primary haemorrhages. The most important risks factors of PTB are age, gender and surgical techniques. The use of anti-inflammatory agents is not associated with a higher risk of PTB. When a PTB is observed, surgical haemostasis is indicated in half of the cases. The anaesthetic management must take into account potential anaemia with or without hypovolaemia and imposes rapid sequence induction. This complication is potentially life threatening. An optimisation of new surgical techniques and a great collaboration between anaesthesiologist and surgeon can decrease morbidity and mortality.