Bleeding after Tonsillectomy: When Is It an Emergency?

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Is Bleeding After Tonsillectomy Normal?

Minor bleeding after a tonsillectomy (tonsil removal) may be nothing to worry about, but in some cases, bleeding could indicate a medical emergency.

If you or your child has recently had a tonsillectomy, it’s important to understand when bleeding means you should call your doctor and when you should head to the ER.

You’re most likely to bleed small amounts right after the surgery or about a week later when the scabs from the surgery fall off. However, bleeding can occur any time during the recovery process.

For this reason, for the first two weeks after surgery, you or your child shouldn’t leave town or go anywhere you can’t reach your doctor quickly.

According to Mayo Clinic, it’s common to see small specks of blood from your nose or in your saliva following tonsillectomy, but bright red blood is a concern. It could indicate a serious complication known as post-tonsillectomy hemorrhage.

Hemorrhage is rare, occurring in about 3.5 percent of surgeries, and is more common in adults than in children.

Primary post-tonsillectomy hemorrhage

Hemorrhage is another word for significant bleeding. If the bleeding happens within 24 hours after a tonsillectomy, it’s called primary post-tonsillectomy hemorrhage.

There are five primary arteries that supply blood to your tonsils. If the tissues surrounding the tonsils don’t compress and form a scab, these arteries may continue to bleed. In rare cases, the bleeding can be fatal.

Signs of primary hemorrhage right after a tonsillectomy include:

  • bleeding from the mouth or nose
  • frequent swallowing
  • vomiting bright red or dark brown blood

Secondary post-tonsillectomy hemorrhage

Between 5 and 10 days after a tonsillectomy, your scabs will begin to fall off. This is an entirely normal process and may cause a small amount of bleeding. Bleeding from scabs is a type of secondary post-tonsillectomy hemorrhage because it occurs more than 24 hours after the surgery.

You should expect to see specks of dried blood in your saliva as the scabs fall off. Bleeding can also happen if scabs fall off too soon. Your scabs are more likely to fall off early if you become dehydrated.

If you are bleeding from your mouth earlier than five days after surgery, contact your doctor right away.

Small amounts of dark blood or dried blood in your saliva or vomit may not be a cause for concern. Continue to drink fluids and rest.

On the other hand, seeing fresh, bright red blood in the days after tonsillectomy is concerning. If you’re bleeding from your mouth or nose and the bleeding doesn’t stop, remain calm. Gently rinse your mouth with cold water and keep your head elevated.

If the bleeding continues, seek immediate medical care.

If your child has bleeding from the throat that is a rapid flow, turn your child onto his or her side to make sure the bleeding doesn’t obstruct breathing and then call 911.

After surgery, contact your doctor if you’re experiencing the following:

  • bright red blood from the nose or mouth
  • vomiting bright red blood
  • fever higher than 102°F
  • inability to eat or drink anything for more than 24 hours

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