Recurrent severe delayed post-tonsillectomy hemorrhage: a case report with a brief review of literature

Tonsillectomy is a common surgical procedure in both children and adults. Post-tonsillectomy hemorrhage (PTH) remains one of the most concerning complications and surgical emergencies. This report describes the case of a 22-year-old male who underwent bilateral tonsillectomy for recurrent tonsillitis. On post-operative days 8 and 12, the patient experienced severe recurrent bleeding requiring two surgical interventions under general anesthesia. Despite massive bleeding, the patient was conscious throughout the episodes, which posed a risk of aspiration. Surgical management included diathermy, cauterization, ligation, and gauze packing, which ultimately arrested the bleeding. This case highlights the importance of ensuring patient awareness, early recognition, and rapid intervention in managing post-tonsillectomy hemorrhage, as well as the challenges in airway management during these crises. The rarity of recurrent post-tonsillectomy massive hemorrhage in the absence of major hematological or anatomical abnormalities makes this case particularly unusual and noteworthy.