Abstract:
BACKGROUND:Post-tonsillectomy hemorrhage (PTH) remains a significant complication. There are no guidelines for Pediatric Emergency Department (PED) disposition of children with secondary PTH. OBJECTIVES:To describe the incidence, clinical characteristics and interventions required by children presenting to a PED with secondary PTH. To identify patient and clinical characteristics associated with need for operative/inpatient intervention. METHODS:Retrospective chart review of healthy children 1-18 years with secondary PTH from 2005 to 2012. Demographics, clinical and oropharynx findings, laboratory data, intervention type and ED disposition were recorded. RESULTS:We encountered 181 children with 193 episodes of PTH. One hundred and twenty one patients were included in the final analysis. Secondary PTH rate was 2.3%. Only a minority of patients were hypotensive (3.3%) or had hemoglobin<10g/dl (9.5%) at presentation. 65.3% Children had positive oropharyngeal exam: clot 39 (49.4%) patients; ooze 17 (21.5%) patients; ooze+clot in 5 (6.3%) patients or active bleeder in 18 (22.8%) patients. Eighty seven (71.9%) patients were admitted; 74 (61.1%) patients required active intervention: medical 14.8%, surgical 74.4% or both 10.8%. Thirty seven children needed immediate operative intervention. Only positive oropharyngeal exam and age ≥6 years were significantly associated with need for intervention. None of the patients with a confirmed normal oropharyngeal exam at the initial visit required any intervention either medical or surgical. The rate of return visit for recurrent PTH was found to be similar for both the admitted and the discharged group. No patient returned with a life threatening hemorrhage. CONCLUSIONS:Majority of children with secondary PTH were admitted and nearly 3/5th of them required an intervention. Our data suggests that healthy children <6 years with a confirmed normal oropharyngeal exam are less likely to require an intervention and may be candidates for safe discharge from the ED provided reliability of return for recurrence can be assured.
journal_name
Int J Pediatr Otorhinolaryngoljournal_title
International journal of pediatric otorhinolaryngologyauthors
Arora R,Saraiya S,Niu X,Thomas RL,Kannikeswaran Ndoi
10.1016/j.ijporl.2014.11.034subject
Has Abstractpub_date
2015-02-01 00:00:00pages
165-9issue
2eissn
0165-5876issn
1872-8464pii
S0165-5876(14)00651-Xjournal_volume
79pub_type
杂志文章abstract:OBJECTIVES:Analyze the anatomical and audiological success rates of myringoplasty in children with craniofacial anomaly, cleft palate and compare them to a control group. METHODS:Retrospective review of medical records for all children who underwent myringoplasty between 1997 and 2007. The following data was recorded:...
journal_title:International journal of pediatric otorhinolaryngology
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abstract::Primary chondroid tumors of the larynx constitute less than 1% of all laryngeal tumors and are usually prevalent in adults. Relevant English literature presents only two pediatric laryngeal chondroma cases. In this paper, a novel pediatric case of laryngeal chondroma presenting as an external laryngeal mass is reporte...
journal_title:International journal of pediatric otorhinolaryngology
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abstract:OBJECTIVES:The purpose of this study is to find average nasalance values of Turkish syllables with the nasometer. METHODS:This study is done at Hacettepe University Department of Otolaryngology Audiology and Speech Pathology Unit with 50 participating children. RESULTS:The normative nasalance values of Turkish phonem...
journal_title:International journal of pediatric otorhinolaryngology
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abstract::A group of 75 children with language/learning disorders were screened for middle ear problems using serial tympanometry and otoscopy. Using a fail criterion of -200 mm H2O for tympanometry, 68% of the ears identified as pathological by otoscopy were identified by two serial tympanometry screens. The concurrence of oto...
journal_title:International journal of pediatric otorhinolaryngology
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journal_title:International journal of pediatric otorhinolaryngology
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2006-09-01 00:00:00
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更新日期:2019-05-01 00:00:00
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pub_type: 杂志文章
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journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
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更新日期:2012-08-01 00:00:00
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journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
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更新日期:2006-04-01 00:00:00