Upper airway obstruction secondary to warfarin-induced sublingual hematoma.
Sublingual hematoma is a rare but potentially fatal complication of oral warfarin sodium. Less than ten cases are reported in the English-language literature with only two of these appearing in the otolaryngologic literature. Spontaneous bleeding into the sublingual and submaxillary spaces creates a "pseudo-Ludwig's" phenomenon with elevation of the tongue and floor of mouth and subsequent airway compromise. Two new cases, along with a review of the literature are presented. Management is directed at prompt control of the airway and reversal of the coagulopathy. Sore throat is a uniform, early complaint that should be taken seriously in any patient receiving oral anticoagulation therapy.
Cohen
A F
AF
Department of Otorhinolaryngology, Montefiore Medical Center-Albert Einstein College of Medicine, Yeshiva University, Bronx, NY 10467.
Warman
S P
SP
D000368:Aged; D000402:Airway Obstruction / Q000209:etiology* / Q000473:pathology; D004630:Emergencies; D005260:Female; D006406:Hematoma / Q000139:chemically induced* / Q000150:complications / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D006472:Oral Hemorrhage / Q000139:chemically induced* / Q000150:complications / Q000473:pathology; D014060:Tongue Diseases / Q000139:chemically induced* / Q000150:complications / Q000473:pathology; D014859:Warfarin / Q000009:adverse effects*
D014859:Warfarin