• Arch Otolaryngol · Jun 1989

    Review Case Reports

    Upper airway obstruction secondary to warfarin-induced sublingual hematoma.

    • A F Cohen and S P Warman.
    • Department of Otorhinolaryngology, Montefiore Medical Center-Albert Einstein College of Medicine, Yeshiva University, Bronx, NY 10467.
    • Arch Otolaryngol. 1989 Jun 1;115(6):718-20.

    AbstractSublingual hematoma is a rare but potentially fatal complication of oral warfarin sodium. Less than ten cases are reported in the English-language literature with only two of these appearing in the otolaryngologic literature. Spontaneous bleeding into the sublingual and submaxillary spaces creates a "pseudo-Ludwig's" phenomenon with elevation of the tongue and floor of mouth and subsequent airway compromise. Two new cases, along with a review of the literature are presented. Management is directed at prompt control of the airway and reversal of the coagulopathy. Sore throat is a uniform, early complaint that should be taken seriously in any patient receiving oral anticoagulation therapy.

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