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Case Reports
. 2001 Apr;22(4):713-6.

Endovascular treatment of hemorrhage after tonsillectomy in children

M J Opatowsky  1 , J D Browne, W F McGuirt Jr, P P Morris
Affiliations
Case Reports

Endovascular treatment of hemorrhage after tonsillectomy in children

M J Opatowsky et al. AJNR Am J Neuroradiol. 2001 Apr.

Abstract

Endovascular therapy for hemorrhage after tonsillectomy or adenoidectomy is an important adjunct to the definitive treatment of this life-threatening occurrence. We report two cases of hemorrhage after tonsillectomy and/or adenoidectomy and describe the endovascular management of this complication in children.

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Figures

<sc>fig</sc> 1.
fig 1.
Case 1: 10-year-old girl with PTAH. A, Right common carotid artery angiogram shows elongation and abrupt truncation of the ascending palatine artery (arrow). This finding was considered suspicious in light of recent PTAH. B, An ECA angiogram reveals coil embolization of the distal ascending palatine artery (solid arrow). Mild catheter-induced spasm is noted along the main ECA trunk (open arrow) that is not apparent in A.
<sc>fig</sc> 2.
fig 2.
Case 2: 5-year-old girl with PTAH. A, An ECA angiogram shows proximal irregularity of the lingual artery (arrow). A subsequent selective lingual artery injection showed free extravasation of contrast material from this point, confirming the source of PTAH. B, Coil embolization of the proximal lingual artery (solid arrow). A portion of the distal lingual artery is reconstituted via generous collateral ECA branches (open arrow). This situation is commonly encountered in the ECA territory and can contribute to rebleeding, which may be minimized by embolization distal and proximal to the site of injury.
<sc>fig</sc> 3.
fig 3.
Drawing shows major arterial supply to the palatine tonsil and adenoidal area. 1, ECA; 2, ICA; 3, ascending pharyngeal artery; 4, lingual artery; 5, facial artery; 6, ascending palatine artery; 7, tonsillar artery; 8, descending palatine artery; 9, internal maxillary artery; 10, dorsal lingual artery; 11, accessory meningeal artery
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