%0 Review
%T Between a Rock and a Hard Place: Anticoagulating an Adolescent with Post-Tonsillectomy Massive PE: A Case Report.
%A Shimomura A
%A Smith S
%A Darki A
%A Kamberos N
%A Charous S
%J Ann Otol Rhinol Laryngol
%V 132
%N 3
%D Mar 2023
%M 35373621
%F 1.973
%R 10.1177/00034894221088178
%X <B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>A chart review and review of the literature.<BR><B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>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.