Airway Chaos: Bleeding Control - Double-Edged Sword

Abstract

Objective: To report a rare case of upper airway obstruction secondary to sublingual hematoma in a patient on warfarin therapy 

Background: Sublingual hematoma is a rare but potentially catastrophic complication of warfarin therapy, which can lead to upper airway obstruction. Emergency tracheostomies are performed for acute upper airway obstruction.

Case Report: We present a case of 67 /F on Warfarin therapy who presented with a spontaneous sublingual hematoma, causing upper airway obstruction with an INR value of 15. Emergency tracheostomy was performed to secure the airway. Infused with cryoprecipitate, FFP, and whole blood. INR corrected to 1.12. Swelling decreased, and the patient was discharged on post-operative day 13.

Conclusion: Upper airway obstruction is a rare but potentially serious complication of warfarin therapy. Reversal of anticoagulation with a low threshold for artificial airway placement in the event of airway compromise leads to a favorable outcome