Boon Tat Yeap, Muniandy Rajesh Kumar, Ng Mooi Hang Lily
Medicine Based Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.
Department of Anaesthesiology and Critical Care, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia.
Case Rep Anesthesiol. 2018 Dec 17;2018:4245809. doi: 10.1155/2018/4245809. eCollection 2018.
A 79-year-old lady, who was taking warfarin, presented to the Emergency Department with a painless anterior neck swelling, which was associated with hoarseness of voice, odynophagia, and shortness of breath. She first noticed the swelling after she removed her dentures in the evening. On examination, she had an increased respiratory rate. There was a large submandibular swelling at the anterior side of her neck. Upon mouth opening, there was a hematoma at the base of her tongue, which extended to both sides of the tonsillar pillars. The patient was intubated with a video laryngoscope due to her worsening respiratory distress. Intravenous vitamin K and fresh frozen plasma were given immediately. The patient was admitted to the ICU for ventilation and observation. The hematoma subsided after 2 days and she was discharged well.
一位79岁正在服用华法林的女性因无痛性颈部前方肿胀前往急诊科就诊,该肿胀伴有声音嘶哑、吞咽疼痛和呼吸急促。她是在晚上取下假牙后首次注意到肿胀的。检查时,她的呼吸频率加快。颈部前方有一个巨大的颌下肿胀。张口时,舌根部有一个血肿,延伸至扁桃体柱两侧。由于呼吸窘迫加重,患者通过视频喉镜进行了插管。立即给予静脉注射维生素K和新鲜冰冻血浆。患者被收入重症监护病房进行通气和观察。2天后血肿消退,她康复出院。