Upper airway obstruction by sublingual hematoma: a complication of anticoagulation therapy with acenocoumarol.
Upper airway obstruction secondary to the use of oral anticoagulants has been reported. In most of the cases, it is produced by retropharyngeal and laryngeal hematomas. The sublingual space is an extremely rare site for bleeding, but this constitutes a life-threatening complication, it must be considered as an emergency situation, and the main priority is to secure patient's airway. We recommend immediate reversal of the anticoagulation therapy, preferably with fresh frozen plasma. The surgical drainage usually is not recommended. We present what is to our knowledge the 10th case reported of an airway obstruction due to sublingual hematoma after the administration of oral anticoagulants, and the third one due to the use of acenocoumarol.
González-García
Raúl
R
Department of Oral and Maxillofacial Surgery, University Hospital La Princesa (Autónoma University), Madrid, Spain. raugg@mixmail.com
Schoendorff
Guillermo
G
Muñoz-Guerra
Mario F
MF
Rodríguez-Campo
Francisco J
FJ
Naval-Gías
Luis
L
Sastre-Pérez
Jesús
J
D000074:Acenocoumarol / Q000009:adverse effects*; D000284:Administration, Oral; D000402:Airway Obstruction / Q000139:chemically induced* / Q000601:surgery; D000925:Anticoagulants / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000188:drug therapy; D006406:Hematoma / Q000139:chemically induced*; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D009060:Mouth Floor; D011517:Prothrombin Time; D014139:Tracheostomy; D020246:Venous Thrombosis / Q000188:drug therapy
D000925:Anticoagulants; D000074:Acenocoumarol