Post-operative haemorrhage after acute bilateral tonsillectomy in patients with peritonsillar abscess: prevalence, treatment, risk factors, and side of bleeding.

Bilateral quinsy tonsillectomy (QT) in patients with peritonsillar abscess (PTA) is associated with the risk of post-tonsillectomy haemorrhage (PTH) and current literature finds a significantly higher risk of PTH contralaterally to the quinsy. To determine the prevalence of PTH in a large cohort of patients undergoing QT, explore risk factors for PTH, describe our methods of treatment, and evaluate if contralateral haemorrhage is more common than ipsilateral haemorrhage. All patients undergoing QT at Aarhus University Hospital in the period 2001-2017 were included in the study. One hundred sixteen of 1671 (6.9%) QT patients were admitted with PTH. PTH patients were significantly more frequently males (66%) and infected with Streptococcus group A (GAS) (31%) compared to QT patients without PTH (53% and 18%, respectively) ( = .005 and  = .002, respectively). Haemostasis was obtained in general anaesthesia ( = 61) or local anaesthesia ( = 28) and stopped spontaneously in 25 patients. The side of PTH was not associated with the side of PTA (ipsilateral ( = 41), contralateral ( = 43), and bilateral PTH ( = 23),  = .93). Our findings question if unilateral QT is preferable to bilateral QT when the PTA does not respond to conservative treatment, especially in males with GAS-positive PTA.