UPPER AIRWAY OBSTRUCTION: DELAYED COMPLICATION OF WARFARIN THERAPY

Abstract

AIM- Report an unusual presentation of delayed complication of warfarin therapy leading to airway compromise. Warfarin is a BACKGROUNDwell-known oral anticoagulant and its major adverse side effect is bleeding (1-10%).Spontaneous hematoma of the sublingual and lingual space is an extremely rare and life threatening complication of warfarin sodium use and can lead to upper airway obstruction from elevation of the oor of mouth and tongue. -The case of a 40 year old male with complaints of swelling be CASE DESCRIPTION low chin and oor of mouth pushing the tongue backwards since 2 days and difculty speaking and swallowing since 1 day and difculty breathing since the past few hours is reported here. History revealed prolonged warfarin therapy. It was managed conservatively with withdrawal of warfarin and administration of Vitamin K and FFP. Prolonged warfarin therapy can lead to hematoma formation in the oor of mouth a CONCLUSION- nd neck swelling which can mimic Ludwig angina. The case can be managed conservatively with careful observation to avoid sudden upper airway obstruction.CLINICAL SIGNIFICANCE- Reporting of such case is warranted due to the need to create awareness of this life threatening complication of warfarin therapy, to preclude any diagnostic dilemma and to share our management of this dreaded complication.