Spontaneous lingual and sublingual haematoma: a rare complication of warfarin use

Büyüklü, Mutlu; Bakırcı, Eftal Murat; Topal, Ergün; Ceyhun, Gökhan

doi:10.1136/bcr-2014-204168

Cited by 10 publications

(13 citation statements)

References 12 publications

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“…The mean dose of warfarin taken by the patients was 5.34 ± 2.58 mg. The indications for warfarin were as follows: Mechanical valves (MVs) ( n = 11, 29.73%),[ 2 4 5 6 7 8 9 10 11 ] atrial fibrillation (AF) ( n = 10, 27.03%),[ 3 12 13 14 15 16 17 18 19 20 ] venous thromboembolism (VTE) ( n = 9, 24.32%),[ 1 21 22 23 24 25 26 27 28 ] chronic thrombophlebitis ( n = 2, 5.41%),[ 29 30 ] and polycythemia vera ( n = 1, 2.70%). [ 31 ] The indication of anticoagulation was unclear in four cases.…”

Section: Resultsmentioning

confidence: 99%

“…Conservative management with vitamin K, fresh frozen plasma (FFP), or prothrombin complex concentrate (PCC) was instituted in 18 (48.65%)[ 2 3 6 8 9 11 12 13 14 15 17 18 19 20 27 32 ] cases Table 2 . Cricothryrotomy was performed in two (5.41%) cases,[ 21 23 ] tracheotomy in 12 (32.43%) cases,[ 1 4 5 11 21 22 23 24 25 26 31 33 ] endotracheal intubation in five (13.51%) cases,[ 1 4 10 22 28 ] nasotracheal intubation in four (10.81%) cases,[ 5 7 16 29 ] and surgical evacuation of hematoma in two (5.41%) cases.…”

Section: Resultsmentioning

confidence: 99%

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Upper airway hematoma secondary to warfarin therapy: A systematic review of reported cases

et al. 2015

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Upper airway hematoma (UAH) is a rare but life-threatening complication of oral anticoagulants requiring early recognition. However, no consensus exists regarding the best approach to treatment. We therefore, sought to systematically review the published literature on UAH to elaborate its demographic and clinical characteristics, treatment, complications, and outcomes. A systematic electronic search of PubMed and EMBASE for case reports, case series, and related articles of UAH related to warfarin published from inception (November 1950) to March 2015 was carried out. Categorical variables were expressed as percentage and continuous variables as mean ± standard deviation (SD). Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 20.0. All cases were reported to have UAH as a complication of anticoagulation therapy with warfarin. Demographic and clinical characteristics, treatment, complications and outcomes of UAH were studied. Thirty-eight cases of UAH were identified from 34 reports in the literature. No gender preponderance (male = 52.78%) was seen and the average age of presentation was 60.11 ± 12.50 years. Dysphagia, sore throat, and neck swelling were the most common symptoms and the mean international normalized ratio (INR)at presentation was 8.07 ± 4.04. Most cases had sublingual hematoma (66.57%) followed by retropharyngeal hematoma (27.03%). Of the cases, 48.65% were managed conservatively while the rest underwent either cricothyrotomy or intubation with the time to resolution being 7.69 ± 5.44 days. UAH is a rare butpotentially serious complication of warfarin therapy. It is more common in the elderly population with supratherapeutic INR; inciting events were present in many cases. Overall, it has a good prognosis with significant morbidity present only if concomitant respiratory compromise is present. Reversal of anticoagulation with low threshold for artificial airway placement in the event of airway compromise leads to a favorable outcome in most cases.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Upper airway hematoma secondary to warfarin therapy: A systematic review of reported cases

et al. 2015

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“…The spontaneous presentation without traumatic event is a rare entity, and is thought to happen due to aneurismal changes in the facial or lingual arteries [4]. Elderly patients with diabetes mellitus, arterial hypertension [4], anticoagulation treatment with warfarin [1,2], thrombocytopenia induced by heparin [5], or thrombolytic therapy as Tenecteplase [3] have an increased risk of rupture of these aneurysms.…”

Section: Discussionmentioning

confidence: 99%

“…Its spontaneous presentation is commonly described in patients on anticoagulation therapy [1,2]. There are some cases related to the tissue plasminogen activators (tPAs), accepted as a therapy for selected instances of acute ischemic cerebrovascular events, such as myocardial infarction, pulmonary embolism, portal vein thrombosis and deep venous thrombosis [3].…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Lingual Hematoma: A Rare Entity

M¹

2015

JOENTR

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“…Sublingual hematoma is a rare and potentially life threatening complication of oral anticoagulation [ 1 – 3 ]. Spontaneous intramural small bowel hematoma (SISBH) due to oral anticoagulation is also rare but generally is not life threatening and may improve with medical treatment [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Concurrent Spontaneous Sublingual and Intramural Small Bowel Hematoma due to Warfarin Use

Günaydın¹,

Sivri²,

Sivri

et al. 2015

Case Reports in Emergency Medicine

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Introduction. We present a case of concurrent spontaneous sublingual and intramural small bowel hematoma due to warfarin anticoagulation. Case. A 71-year-old man presented to the emergency department complaining of a swollen, painful tongue. He was on warfarin therapy. Physical examination revealed sublingual hematoma. His international normalized ratio was 11.9. The computed tomography scan of the neck demonstrated sublingual hematoma. He was admitted to emergency department observation unit, monitored closely; anticoagulation was reversed with fresh frozen plasma and vitamin K. 26 hours after his arrival to the emergency department, his abdominal pain and melena started. His abdomen tomography demonstrated intestinal submucosal hemorrhage in the ileum. He was admitted to surgical floor, monitored closely, and discharged on day 4. Conclusion. Since the patient did not have airway compromise holding anticoagulant, reversing anticoagulation, close monitoring and observation were enough for management of both sublingual and spontaneous intramural small bowel hematoma.

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Spontaneous lingual and sublingual haematoma: a rare complication of warfarin use

Cited by 10 publications

References 12 publications

Upper airway hematoma secondary to warfarin therapy: A systematic review of reported cases

Upper airway hematoma secondary to warfarin therapy: A systematic review of reported cases

Spontaneous Lingual Hematoma: A Rare Entity

Concurrent Spontaneous Sublingual and Intramural Small Bowel Hematoma due to Warfarin Use

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