Fatal hemorrhage after tonsillectomy

Feld, Katharina; Mellin, W.; Melzer, B; Rothschild, Markus A.; Fries, Jochen W.U.

doi:10.1007/s00194-021-00502-8

Cited by 2 publications

(2 citation statements)

References 31 publications

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“…The value of this autopsy lies in the exculpation of the operating surgeon from the initial accusation. However, the attempt of a molecular analysis of this conatal condition, was thwarted due to the degradation of the RNA, which would have been necessary for further analysis [28].…”

Section: The Problem Of Time For the Post-mortem Examinationmentioning

confidence: 99%

Insights of Validating Death Certificates through Clinical Autopsies

JWU

2023

austinjsurg

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Background: With decreasing autopsy numbers, the cause of death listed in the death certificate is only based on an external inspection, which is increasingly criticized as insufficient. This investigation analyses 447 death certificates from the archives of the University Hospital of Koeln, Germany and their corresponding autopsy reports from the Institute of Pathology. Methods: For this analysis, quality assurance protocols, death certificates, clinical/autopsy notes, and final autopsy reports were used. Cases were categorized: 1. in four validation classes (Goldman criteria, identifying unknown diseases with therapeutic relevance as cause of death); 2) in four nosological causal chains (WHO ICD10; type: linear/ divergent/ convergent/ complex). Results: Differences in diagnoses between death certificate and autopsy report occurred in 32% (143/447 cases). In 7%, only the autopsy identified the cause of death (Goldman, type 2a). Nosological causal chains were established in 21% (linear/divergent) vs 28% (convergent/complex). Myocardial infarct, septicemia and cardiac insufficiency caused death in more than two thirds of cases. Diabetes and obesity did not play a major role as cause of death. Conclusion: Autopsies are highly advisable if death occurs within 48 hrs. of admission and as sudden death in the hospital setting. Regular interdisciplinary autopsy conferences are important for quality control, assessing cases of the convergent/ complex type. The position of an autopsy commissioner as mediator between relatives, clinicians and pathologists seems recommendable in a hospital setting. While an electronic patient file is still controversial, medical data collection as source of information in emergencies by the patient’s medical practitioner seems advantageous.

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Section: The Problem Of Time For the Post-mortem Examinationmentioning

confidence: 99%

Insights of Validating Death Certificates through Clinical Autopsies

JWU

2023

austinjsurg

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“…The perioperative hemorrhage, postop discomfort as well as postop bleeding are all serious complications that can occur after surgery, or common consequences or side effects after surgery 4,5 . The mortality associated with tonsillectomy is an uncommon but well-known consequence 6,7 . The tongue swelling, altered taste, eye injury, lip burn, carotid artery injury and a mandibular condyle fracture have all been described as complications to tonsillectomy 8,9 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of Ligasure versus Bipolar Diathermy Tonsillectomy

Saleem¹,

Khan²,

Ali³

et al. 2023

PJMHS

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Aim: To compare the operational time, blood loss and consequences of tonsillectomy with Ligasure versus bipolar diathermy. Methods: A total of 106 individuals were randomized to have their Tonsillectomy done with either Ligasure or bipolar diathermy in this prospective trial. The length of procedure, amount of blood lost during it, degree of post-operative pain and the outcomes all were documented and studied. Results: In total, 106 cases were studied, with 53 cases in to the Ligasure Group and 53 cases to Bipolar Tonsillectomy Group. During surgery, bipolar diathermy group lost more amount of blood. The Ligasure group had an average operative time of 4 minutes less. Both groups had similar degrees of postoperative pain. Despite the fact that the Ligasure group had less postoperative hemorrhages than the diathermy group, there was no statistically significant difference. Conclusions: Study concluded that tonsillectomies using ligasure took longer than those with bipolar diathermy. Both groups had similar perioperative hemostasis. The rate of postoperative bleeding was higher than anticipated. Keywords: Ligasure, bipolar diathermy hemorrhage, hemostasis, blood loss during surgery

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Fatal hemorrhage after tonsillectomy

Cited by 2 publications

References 31 publications

Insights of Validating Death Certificates through Clinical Autopsies

Insights of Validating Death Certificates through Clinical Autopsies

Comparison of Ligasure versus Bipolar Diathermy Tonsillectomy

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