Parvizi Sahar, Mackeith Samuel, Draper Mark
Department of Ear, Nose Throat Surgery, Milton Keynes Hospital NHS Foundation Trust, Milton Keynes, UK.
BMJ Case Rep. 2011 May 3;2011:bcr0320113930. doi: 10.1136/bcr.03.2011.3930.
Anticoagulation with warfarin is commonly used for prevention of thromboembolic events in patients with atrial fibrillation. Bleeding is the main side effect of anticoagulation. We report the case of a 66-year-old man who developed two spontaneous synchronous upper airway haematomas while on warfarin therapy. To our knowledge, this is the first reported case of a sublingual haematoma presenting simultaneously with supraglottic laryngeal haematomas. Upper airway haematomas are rare in the absence of a history of trauma but need to be urgently assessed due to their life-threatening potential. Clinicians should be aware of the possibility of haematomas involving the upper airway in patients on anticoagulant therapy, particularly if complaining of red flag symptoms such as acute onset dysphonia, odynophagia or airway/breathing difficulties.
华法林抗凝常用于预防心房颤动患者的血栓栓塞事件。出血是抗凝治疗的主要副作用。我们报告一例66岁男性患者，在接受华法林治疗期间发生了两个自发性同步上气道血肿。据我们所知，这是首例舌下血肿与声门上喉血肿同时出现的报道病例。上气道血肿在无创伤史的情况下较为罕见，但因其具有危及生命的可能性，需要紧急评估。临床医生应意识到接受抗凝治疗的患者发生上气道血肿的可能性，特别是当患者出现如急性发声困难、吞咽痛或气道/呼吸困难等警示症状时。
