Bleeding After a Tonsillectomy

Bleeding after tonsillectomy is considered an emergency due to the close proximity of major arteries to the tonsils. However, many people have their tonsils removed every day in the United States and most do just fine.

That said, the frequency of postoperative bleeding can vary greatly depending on the technique used and the nature of the procedure. Complications from a tonsillectomy vary with the worst complication being death.

Bleeding after tonsillectomy
Illustration by Joshua Seong. © Verywell, 2018. 

Checking for Post-Operative Bleeding

Tonsillectomies are among the most common surgeries in the world. Bleeding afterward is rare, so it should be taken seriously. Signs of bleeding after a tonsillectomy include:

  • Bright red blood coming from the mouth or nose
  • Frequent swallowing
  • Spitting out bright red blood
  • Tasting blood in your mouth—a metallic taste
  • Vomiting bright red or old blood—old blood is dark brown in color and is sometimes described as looking like coffee grounds

When Bleeding Would Occur

Bleeding after tonsillectomy is most likely to occur right after surgery or about a week later when the scabs come off.

Bleeding can also occur at any point in the recovery process, which takes around 2 weeks.

You may hear your healthcare provider refer to primary hemorrhage or secondary hemorrhage. All this refers to is the length of time that passed before bleeding occurred:

  • Primary hemorrhage is bleeding that occurs within 24 hours after a tonsillectomy
  • Secondary hemorrhage is bleeding that occurs more than 24 hours after a tonsillectomy

Taking Action

If there is significant bleeding immediately after surgery, you may return back to the OR to have additional cauterization.

If significant bleeding occurs or your healthcare provider suspects bleeding problems, you may be kept in the hospital overnight. However, a tonsillectomy rarely requires hospitalization and is usually considered an outpatient procedure.

If you suspect any of the signs listed above, you may wish to look at the tonsil beds. You can do this using a flashlight and a tongue depressor or popsicle stick. Depending on how long it's been since you had surgery, your tonsil beds should look white or dark brown.

If your tonsil beds are covered with bright red blood or you see bright red streaks running down the back of your throat, you should seek medical attention immediately.

It is not uncommon to swallow blood during a tonsillectomy and then vomit old blood the day of surgery. If this happens, use the method above to take a look at the tonsil beds. If you can't see them or if you are uncomfortable doing this, contact your healthcare provider for help.

If you see bright red blood, contact your healthcare provider right away. In most cases, bleeding after tonsillectomy can be stopped by cauterizing the tonsil beds but it is important to get emergency medical treatment If you begin bleeding after a tonsillectomy or suspect you might be bleeding.

Other Potential Complications

Bleeding is the most common and severe complication to a tonsillectomy. There are, however, other complications that you should look out for and contact a healthcare provider if they are noticed, including:

  • Dehydration
  • Difficulty breathing
  • Infection

Generally speaking, tonsillectomies are very safe procedures. However, due to the risks involved in having a tonsillectomy, it is important for you to be informed and know how to check for bleeding tonsils to prevent the worst complications, as these can occur.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. University of Iowa Health Care. Tonsillectomy bleed (hemorrhage) management (post-tonsillectomy hemorrhage).

  3. Children’s Minnesota. Patient & family education materials, Tonsillectomy: information.

  4. Hussain S, O'connell ferster AP, Carr MM. Time between first and second posttonsillectomy bleeds. Int J Otolaryngol. 2017;2017:3275683. doi:10.1155/2017/3275683

  5. Richardson, M, Friedman, N. Clinician's guide to pediatric sleep disorders. Boca Raton, FL: CRC Press.

  6. Pope, J. MyHealthAlberta. Problems after tonsillectomy in children: care instructions.

Additional Reading

By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.