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.
Keywords
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.
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.
Keywords
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.
Details
| Primary Language | English |
|---|---|
| Subjects | Emergency Medicine |
| Journal Section | Case Reports |
| Authors | |
| Publication Date | December 27, 2023 |
| Submission Date | October 27, 2023 |
| Acceptance Date | December 6, 2023 |
| Published in Issue | Year 2023 Volume: 5 Issue: 3 |
Cite
Indexing and Abstracting