Accidental Tonsil Injury During Examination
I’m a 26-year-old male, standing 6 feet tall, with a history of mitral valve prolapse and thalassemia minor. Recently, during an examination by an ENT specialist for a suspected cyst on my tonsil, the doctor performed a swab test to check for any bacterial infection. However, it appears that during the procedure, she may have unintentionally inserted the swab tip into a pre-existing crypt on my tonsil, leading to some discomfort. Initially, there was a natural crypt present, but now it appears enlarged and seems to have been cut in some way. Fortunately, there hasn’t been any active bleeding following the incident, and the bleeding that occurred was minimal at best. The doctor assured me that the area will heal naturally, but I wanted to consult here to confirm that this is accurate. I did some online research regarding tonsil injuries, and I came across information about ruptured tonsils, which caused me concern about my condition. I would like to share some pictures to illustrate the change; while the difference isn't massive, there is observable enlargement and it looks a bit gash-like.
Answers (1)
7/28/2025, 9:20:43 PM
OpenHealth AI
It sounds like you have had an uncomfortable experience during your examination, and it’s understandable to feel concerned about any changes to your tonsil after a procedure. Based on your description and the reassurance from your ENT specialist, here are the main points regarding your situation:
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Healing Process: It's quite common for minor trauma to the tonsils, such as what you described from the swab test, to lead to temporary discomfort or localized swelling. Typically, tonsils heal well and any minor cuts or abrasions will usually resolve on their own without complications.
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Ruptured Tonsils vs. Minor Injury: A ruptured tonsil is more severe than what you appear to be experiencing. Since there is no active bleeding and only minimal bleeding was noted, it is likely your injury is mild. Tonsil crypts can also vary in appearance, and their size might not directly correlate with any serious issues.
Next Steps and Home Care
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Monitor Symptoms: Keep an eye on the site for any signs of increased swelling, redness, or discharge. Since you are already aware of the initial concerns, note any changes in your condition.
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Manage Discomfort: If you experience discomfort or soreness, consider saltwater gargles (1 teaspoon of salt in a glass of warm water) to help soothe the throat and keep the area clean. Over-the-counter pain relievers like ibuprofen or acetaminophen can also help if needed.
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Hydration and Diet: Stay well-hydrated and consume soft foods that are easy to swallow to avoid further irritation of the tonsil area.
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Avoid Irritants: During the healing period, try to avoid smoking, very hot foods or drinks, and excessive talking or shouting, as these can irritate the tonsils further.
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Follow-Up: If you notice worsening symptoms—such as increased pain, fever, difficulty swallowing, or the area becoming increasingly infected—consider reaching back out to your ENT specialist for further advice.
Taking these steps should support your healing process. If you have specific concerns or find that your symptoms are not improving, it can be beneficial to discuss them with your healthcare provider. I'm here to help you with any further questions or clarifications you may need.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.