Upper Airway Obstruction Secondary to Warfarin-Induced Sublingual Hematoma

Emergency Tracheostomy for Acute Hematoma of the Floor of the Oral Cavity in Patient Under Anticoagulant Therapy: Case Report and Systematic Review

“…The spontaneous disappearance of the hematoma is the natural course of bleeding. It only occurred if oral anticoagulation was stopped and FFP and/ or vitamin K were administered [2,[7][8][9]. As it has been previously observed in our case, the use of subcutaneous heparin or antiplatelet drugs would be desirable if patient needed an ulterior coagulation treatment [2].…”

Lingual hematoma threatening airway obstruction in a patient on oral anticoagulation with warfarin

“…In all cases, a sore throat seemed to be an early symptom and dysphagia, hoarseness, drooling or respiratory distress follows [2]. In the present case, dysarthria and drooling were the early symptoms and cough was probably due to inhalation of some of the secretions.…”

“…Surgical drainage of the hematoma is generally not indicated [2,11]. In our patient, no surgical intervention was performed.…”

Management of upper airway obstruction secondary to warfarin therapy: the conservative approach

“…7 At least seven of the previously described reports managed such patients by means of cricothyroidotomy or tracheostomy, 1 -6 and one author advocates early tracheostomy as the preferred method of management. 6 Our experience in this case indicates otherwise. Factors critical to our success included the controlled setting (in an ICU), optimal anaesthesia (including extravagant use of topical lignocaine) and use of nasal intubation.…”