title: Upper airway obstruction by epiglottis and arytenoids hematoma in a patient treated with warfarin sodium.
abstract: With the increase in the number of patients undergoing warfarin therapy, reports of complications due to such therapy have become frequent. Although upper airway obstruction secondary to bleeding resulting from warfarin therapy is rare, it is a life-threatening complication because of the risk of airway obstruction. Only one previous case of hematoma of the epiglottis and arytenoids has been reported. We here in report a case of an 83-year-old woman on warfarin therapy who presented with a sore throat. On flexible nasoendoscopy, edema of the epiglottis and bilateral arytenoids with a red and purple hue were observed. The left true vocal cord was erythematous, but the airway was adequately maintained. The PT-INR of the patient was 10. She was managed conservatively and had a good course.
authors.affiliation: Department of Otolaryngology, Sendai City Hospital, and Department of Otolaryngology-Head & Neck Surgery, Tohoku University School of Medicine, Sendai, Japan. ryoukich@hotmail.com
authors.forename: Ryoukichi
authors.initials: R
authors.lastname: Ikeda
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Chiba
authors.forename: Shigeki
authors.initials: S
authors.lastname: Gorai
authors.forename: Toshimitu
authors.initials: T
authors.lastname: Kobayashi
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001193:Arytenoid Cartilage / Q000473:pathology*; D002437:Cefazolin / Q000627:therapeutic use; D004825:Epiglottis / Q000473:pathology*; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006406:Hematoma / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D006854:Hydrocortisone / Q000031:analogs & derivatives / Q000627:therapeutic use; D007262:Infusions, Intravenous; D015508:Nasal Obstruction / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology*; D010612:Pharyngitis / Q000139:chemically induced / Q000175:diagnosis; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D005343:Fibrinolytic Agents; D014859:Warfarin; D002437:Cefazolin; C007133:hydrocortisone hemisuccinate; D006854:Hydrocortisone