Document 0099
 DOCN  M95A0099
 TI    Bleeding after tonsillectomy in severe von Willebrand's disease.
 DT    9510
 AU    Alusi GH; Grant WE; Lee CA; Pasi KJ; Stearns MP; Department of
       Otolaryngology, Head and Neck Surgery, Royal Free; Hospital, School of
       Medicine, London.
 SO    J Laryngol Otol. 1995 May;109(5):437-9. Unique Identifier : AIDSLINE
       MED/95318626
 AB    A case is reported of a HIV-positive patient with severe von
       Willebrand's disease describing the bleeding complications during and
       after tonsillectomy. This patient underwent surgery for asymmetrical
       tonsillar hypertrophy. The tonsils were spontaneously haemorrhaging and
       there therefore was a suspicion of neoplasia. Despite close cooperation
       between the ENT Department and the Haemophilia Centre, involving
       per-operative Factor VIII monitoring and replacement, the patient
       suffered both protracted primary and secondary haemorrhages. We report
       this as a cautionary tale as our previous experience with mild to
       moderate haemophilia has been uncomplicated, but on this occasion there
       was massive haemorrhage. We feel that tonsillectomy should not be
       undertaken in a patient with a severe bleeding disorder without an
       absolute indicate.
 DE    von Willebrand's Disease/*COMPLICATIONS  Adult  Case Report
       Hemorrhage/*ETIOLOGY  Human  HIV Infections/*COMPLICATIONS  Male
       Tonsillectomy/*ADVERSE EFFECTS/CONTRAINDICATIONS  JOURNAL ARTICLE

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