Darwish Mohamed, Al Nagbi Fathiya, Aljanaahi Hamed, Alao David Olukolade
Department of Emergency Medicine, Tawam Hospital, Al Ain, Abu Dhabi, UAE.
Emergency Department, Plymouth Hospitals NHS Trust, Plymouth, England, UK
BMJ Case Rep. 2025 Aug 28;18(8):e264280. doi: 10.1136/bcr-2024-264280.
Gastrointestinal, genitourinary and intracranial bleeding are common complications of warfarin therapy. However, airway haematomas can occur in patients with supratherapeutic International Normalised Ratio. The involvement of the airway should be suspected in patients who present with dysphagia, drooling, dysphonia and inability to speak. Conservative management is often sufficient, but a definitive airway, such as endotracheal intubation or a surgical airway, may sometimes be required.We present the case of a man in his early 50s who had a haematoma of the hypopharynx causing airway obstruction that was successfully treated with an emergency tracheostomy. We discuss the current guidelines on difficult airway management and the role of a multidisciplinary team in managing imminent airway obstruction.
胃肠道、泌尿生殖系统及颅内出血是华法林治疗的常见并发症。然而，国际标准化比值高于治疗范围的患者可能会出现气道血肿。出现吞咽困难、流口水、声音嘶哑及无法说话的患者应怀疑气道受累。保守治疗通常就足够了，但有时可能需要建立确定性气道，如气管插管或手术气道。我们报告一例50岁出头男性的病例，该患者下咽血肿导致气道梗阻，通过紧急气管切开术成功治疗。我们讨论了当前关于困难气道管理的指南以及多学科团队在处理即将发生的气道梗阻中的作用。
