فهرست نشریات علمی دسترسی آزاد ایران

Background: Warfarin is a commonly used anticoagulant for the prophylaxis in patients with various cardiovascular conditions like atrial fibrillation, venous thromboembolism, and prosthetic heart valves. A significant side effect of Warfarin overdose is bleeding, which may occur spontaneously or following trauma. The sublingual space is an unusual site for bleeding; however, when it occurs, it represents a life-threatening complication. A hematoma formed at this site must be treated as a medical emergency to secure the patient's airway.Case presentation: We report a case of a hematoma involving the sublingual and deep neck spaces in a female patient who was on warfarin therapy following mitral and aortic valve replacement. While on anticoagulant treatment, she had a fall and blunt injury to the lower back, which was not considered serious. However, after 10 days, she presented with an increasing hematoma in the sublingual space, which progressed to involve the deep neck spacesDiscussion: With appropriate measures to counter the effect of Warfarin, the hematoma subsided without much compromise in the airway. In severe sublingual hematoma, immediate reversal of anticoagulation treatment, with vitamin K and Fresh Frozen Plasma (FFP), along with discontinuation of anticoagulants, is recommended. Close monitoring is required to detect potential airway obstruction, and the patient should be informed about the possible need for endotracheal intubation or tracheostomy.