ABSTRACT
This chapter presents a case study of a 6-year-old child who is presented with a 1-hour history of frank bleeding from the mouth. Twelve hours ago, the child had a similar episode of bleeding at home, which lasted 15 minutes before self-resolution. Five days ago, he underwent a tonsillectomy under general anaesthesia for recurrent acute tonsillitis. The child has also vomited twice in the last hour; the contents of the vomitus are fresh blood and blood clots. The child is otherwise fit and well, and this was his first operation. There is no family history of bleeding disorders. All patients must be assessed immediately and admitted for observation as a self-limiting bleed can preclude a larger bleed within 24 hours. The indications for urgent surgical intervention are active bleeding, haemodynamic instability or a known clotting abnormality. This child requires multidisciplinary management in the resuscitation area by an ENT surgeon, senior anaesthetist, paediatrician and emergency medicine doctor.
