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Warfarine Bağlı Dil Altı Şişliği: Bir Psödo-Ludwig Angina Olgusu

Year 2023, , 113 - 114, 27.12.2023
https://doi.org/10.55994/ejcc.1382402

Abstract

Psödo-ludwig anjina enfeksiyon dışı nedenlerle dil altında gelişen şişliktir. Bu durumda oral alım bozulması hatta solunum yolu tıkanıklığı gibi ölümcül durumlar gelişebilir Antikoagülan kullanımı nedeniyle literatürde nadiren bildirilmektedir. Bu çalışmada INR değeri normal sınırda olan, diş tedavisi (ağız içi travma) sonrası dil altı şişlik gelişen hastayı sunduk. 68 yaşında bayan hasta, 3 gün önce diş tedavisi yapıldıktan sonra gitgide artan ağız içi şişlik şikayeti ile acil servise başvurdu. Muayenesinde sublingual bölgede 3x5 cm’lik hematom görüldü. Warfarin kesildi olası entübasyon riski açısından takibe alındı. Solunum sıkıntısı gelişmeyen hasta 4 gün sonra taburcu edildi. Ağız içi müdahalelerin güvenle yapılabileceği INR aralığı hala belirsizdir. Diş hekimi, warfarin kullanan hastalarda bu gibi komplikasyonlar gelişebileceğini akılda tutmalı, tedavi öncesi kanama komplikasyonlarına karşı hazırlıklı olmalıdır.

References

  • 1. Cashman E, Shandilya M, Amin M, Hughes J, Walsh M. Warfarin-induced sublingual hematoma mimicking Ludwig angina: conservative management of a potentially life-threatening condition. Ear, Nose & Throat Journal 2011;90(2):E1-E3.
  • 2. Lovallo E, Patterson S, Erickson M, Chin C, Blanc P, Durrani TS. When is “pseudo–Ludwig’s angina” associated with coagulopathy also a “pseudo” hemorrhage?. Journal of Investigative Medicine High Impact Case Reports 2013;1(2).
  • 3. Gupta MK, McClymont LG, El-Hakim H. Case of sublingual hematoma threatening airway obstruction. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research 2003 Nov;9(11):CS95-7.
  • 4. Visser LE, Bleumink GS, Trienekens PH, Vulto AG, Hofman A,Stricker BHC. The risk of overanticoagulation in patients with heart failure on coumarin anticoagulants. British journal of haematology 2004;127(1):85-89
  • 5. Tran HA, Chunilal SD, Harper PL, Tran H, Wood EM, Gallus AS. An update of consensus guidelines for warfarin reversal. Medical Journal of Australia 2013:198(4):198-199.
  • 6. Aframia, DJ, Lalla RV, Peterson DE. Management of dental patients taking common hemostasis-altering medications. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 2007;103:S45-e1.

Warfarin-induced Sublingual Swelling: A Case of Pseudo-Ludwig Angina

Year 2023, , 113 - 114, 27.12.2023
https://doi.org/10.55994/ejcc.1382402

Abstract

Pseudo-Ludwig angina is a swelling that develops generally due to a cause other than an infection and can lead to fatal conditions such as severe respiratory obstruction. Due to anticoagulant use is rarely reported in the literature. This study presented a patient whose INR value was within the normal range and who developed sublingual swelling after dental treatment (intraoral trauma). A 68-year-old female patient was admitted to the emergency department complaining of increasing intraoral swelling on examination with a sublingual 3x5 cm hematoma. Warfarin was stopped, and she was monitored for possible intubation risk in the service. The patient did not develop respiratory distress and was discharged 4 days later. The INR range within which intraoral interventions can be performed safely is still unclear. The dentist should keep in mind that such complications may develop and be prepared for bleeding complications before treatment using warfarin patients.

References

  • 1. Cashman E, Shandilya M, Amin M, Hughes J, Walsh M. Warfarin-induced sublingual hematoma mimicking Ludwig angina: conservative management of a potentially life-threatening condition. Ear, Nose & Throat Journal 2011;90(2):E1-E3.
  • 2. Lovallo E, Patterson S, Erickson M, Chin C, Blanc P, Durrani TS. When is “pseudo–Ludwig’s angina” associated with coagulopathy also a “pseudo” hemorrhage?. Journal of Investigative Medicine High Impact Case Reports 2013;1(2).
  • 3. Gupta MK, McClymont LG, El-Hakim H. Case of sublingual hematoma threatening airway obstruction. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research 2003 Nov;9(11):CS95-7.
  • 4. Visser LE, Bleumink GS, Trienekens PH, Vulto AG, Hofman A,Stricker BHC. The risk of overanticoagulation in patients with heart failure on coumarin anticoagulants. British journal of haematology 2004;127(1):85-89
  • 5. Tran HA, Chunilal SD, Harper PL, Tran H, Wood EM, Gallus AS. An update of consensus guidelines for warfarin reversal. Medical Journal of Australia 2013:198(4):198-199.
  • 6. Aframia, DJ, Lalla RV, Peterson DE. Management of dental patients taking common hemostasis-altering medications. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 2007;103:S45-e1.
There are 6 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Case Reports
Authors

Abdulrahman Naser 0000-0002-0954-6347

Yucel Uzun 0009-0002-0246-2404

Ceyda Karslı 0009-0001-4012-015X

Oya Güven 0000-0002-6389-4561

Lale Tuna 0000-0003-4409-3459

Publication Date December 27, 2023
Submission Date October 27, 2023
Acceptance Date December 6, 2023
Published in Issue Year 2023

Cite

APA Naser, A., Uzun, Y., Karslı, C., Güven, O., et al. (2023). Warfarin-induced Sublingual Swelling: A Case of Pseudo-Ludwig Angina. Eurasian Journal of Critical Care, 5(3), 113-114. https://doi.org/10.55994/ejcc.1382402
AMA Naser A, Uzun Y, Karslı C, Güven O, Tuna L. Warfarin-induced Sublingual Swelling: A Case of Pseudo-Ludwig Angina. Eurasian j Crit Care. December 2023;5(3):113-114. doi:10.55994/ejcc.1382402
Chicago Naser, Abdulrahman, Yucel Uzun, Ceyda Karslı, Oya Güven, and Lale Tuna. “Warfarin-Induced Sublingual Swelling: A Case of Pseudo-Ludwig Angina”. Eurasian Journal of Critical Care 5, no. 3 (December 2023): 113-14. https://doi.org/10.55994/ejcc.1382402.
EndNote Naser A, Uzun Y, Karslı C, Güven O, Tuna L (December 1, 2023) Warfarin-induced Sublingual Swelling: A Case of Pseudo-Ludwig Angina. Eurasian Journal of Critical Care 5 3 113–114.
IEEE A. Naser, Y. Uzun, C. Karslı, O. Güven, and L. Tuna, “Warfarin-induced Sublingual Swelling: A Case of Pseudo-Ludwig Angina”, Eurasian j Crit Care, vol. 5, no. 3, pp. 113–114, 2023, doi: 10.55994/ejcc.1382402.
ISNAD Naser, Abdulrahman et al. “Warfarin-Induced Sublingual Swelling: A Case of Pseudo-Ludwig Angina”. Eurasian Journal of Critical Care 5/3 (December 2023), 113-114. https://doi.org/10.55994/ejcc.1382402.
JAMA Naser A, Uzun Y, Karslı C, Güven O, Tuna L. Warfarin-induced Sublingual Swelling: A Case of Pseudo-Ludwig Angina. Eurasian j Crit Care. 2023;5:113–114.
MLA Naser, Abdulrahman et al. “Warfarin-Induced Sublingual Swelling: A Case of Pseudo-Ludwig Angina”. Eurasian Journal of Critical Care, vol. 5, no. 3, 2023, pp. 113-4, doi:10.55994/ejcc.1382402.
Vancouver Naser A, Uzun Y, Karslı C, Güven O, Tuna L. Warfarin-induced Sublingual Swelling: A Case of Pseudo-Ludwig Angina. Eurasian j Crit Care. 2023;5(3):113-4.

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