Abstract
IntroductionSublingual hematoma secondary to excessive anticoagulation is a rare but potentially fatal condition, and few cases have been documented in the literature.Case presentationWe report the case of a 73-year-old Caucasian woman who attended our Accident and Emergency department with massive sublingual hematoma causing superior displacement of the tongue. The condition was found to be the result of an elevated international normalized ratio, further complicated by a traumatic mandibular denture.ConclusionsIn summary, we recommend the immediate reversal of anticoagulation therapy on admission of patients with severe sublingual hematoma. We further advise surgical decompression/drainage if required and to continue meticulous monitoring. In all cases of early recognition of sublingual hematoma, prompt medical treatment and continuous clinical monitoring is essential, and may prevent the need for a surgical airway procedure.
Highlights
Sublingual hematoma secondary to excessive anticoagulation is a rare but potentially fatal condition, and few cases have been documented in the literature.Case presentation: We report the case of a 73-year-old Caucasian woman who attended our Accident and Emergency department with massive sublingual hematoma causing superior displacement of the tongue
We report the case of a massive sublingual hematoma with superior displacement of the tongue
Hemorrhages caused by a warfarin overdose usually appear in the genitourinary, gastrointestinal, retroperitoneal and intracranial areas and few reports have implied warfarin therapy as a cause of hematoma of the upper airway [2]
Summary
We recommend the immediate reversal of anticoagulation therapy, ideally with Beriplex® prothrombin complex concentrate supplemented with vitamin K, on the admission of patients with severe sublingual hematoma [2]. We further advise surgical decompression/drainage if required and to continue meticulous monitoring. Sublingual hematomas can quickly develop into a lifethreatening condition, and early recognition, prompt medical treatment and continuous clinical monitoring may prevent the need for a surgical airway procedure. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Authors’ contributions AP and MAN were the major contributors to writing the manuscript. DH was involved in the care of our patient and revised the case report. JL was responsible for the medical and surgical care of our patient. All authors read and approved the final manuscript. Competing interests The authors declare that they have no competing interests
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