Between a Rock and a Hard Place: Anticoagulating an Adolescent with Post-Tonsillectomy Massive PE: A Case Report. Journal Article

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Authors: Shimomura, A; Smith, S; Darki, A; Kamberos, N; Charous, S
Article Title: Between a Rock and a Hard Place: Anticoagulating an Adolescent with Post-Tonsillectomy Massive PE: A Case Report.
Abstract: OBJECTIVES: To report a case of a morbidly obese 17-year-old boy who presented 4?days post-tonsillectomy with acute deep venous thromboses and a massive pulmonary embolism. To describe a protocol and decision-making tree for providing anticoagulation in the immediate post-tonsillectomy period. METHODS: A chart review and review of the literature. RESULTS: The patient ultimately did well and had no bleeding from the tonsil beds or further thromboembolic complications. A review of the literature revealed no available data regarding the safety of anticoagulation in the immediate post-tonsillectomy period. CONCLUSIONS: We propose that if anticoagulation is needed within 14?days of tonsillectomy, submaximal anticoagulation with a reversible and titratable anticoagulant may be optimal. A multidisciplinary team approach is needed for these complex cases. Future reporting and investigation of anticoagulation post-tonsillectomy is needed.
Journal Title: The Annals of Otology, Rhinology, and Laryngology
ISSN: 0003-4894; 0003-4894
Publisher: Unknown  
Date Published: 2022