Severe Airway Obstruction due to Massive Retropharyngeal Hematoma in a Warfarin-Taking Patient with a Normal International Normalized Ratio
Warfarin is used as part of the treatment of various diseases, and laboratory monitoring of its effects is required. Airway hematoma secondary to warfarin is rare, but can be fatal because of potential airway obstruction. Rapid definitive airway establishment is crucial if airway obstruction is susp...
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| Format: | Article |
| Language: | English |
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Korean Society of Traumatology
2021-03-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://www.jtraumainj.org/upload/pdf/jti-2020-0028.pdf |
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| author | Hyun Young Cho Hyung Il Kim |
| author_facet | Hyun Young Cho Hyung Il Kim |
| author_sort | Hyun Young Cho |
| collection | DOAJ |
| description | Warfarin is used as part of the treatment of various diseases, and laboratory monitoring of its effects is required. Airway hematoma secondary to warfarin is rare, but can be fatal because of potential airway obstruction. Rapid definitive airway establishment is crucial if airway obstruction is suspected. This complication is more likely to occur in those with elevated coagulation laboratory values. However, we experienced a patient in whom a massive retropharyngeal hematoma caused airway obstruction after a non-severe motor vehicle collision. The patient had been taking warfarin, and had coagulation parameter values within the normal ranges. A major fracture or hemorrhage was not anticipated. Upon examination, a massive retropharyngeal hematoma was noted. Orotracheal intubation failed due to an airway obstruction. Emergency tracheostomy and an operation for hematoma removal were performed. Physicians must always consider the possibility of airway hematoma in warfarin-taking patients with normal coagulation values regardless of the severity of mechanism of injury |
| format | Article |
| id | doaj-art-8059362d29b746629a0017243f6293a6 |
| institution | Kabale University |
| issn | 1738-8767 2287-1683 |
| language | English |
| publishDate | 2021-03-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-8059362d29b746629a0017243f6293a62025-02-03T11:12:10ZengKorean Society of TraumatologyJournal of Trauma and Injury1738-87672287-16832021-03-01341576010.20408/jti.2020.00281054Severe Airway Obstruction due to Massive Retropharyngeal Hematoma in a Warfarin-Taking Patient with a Normal International Normalized RatioHyun Young Cho0Hyung Il Kim1 Department of Emergency Medicine, Dankook University Hospital, College of Medicine, Dankook University, Cheonan, Korea Department of Emergency Medicine, Dankook University Hospital, College of Medicine, Dankook University, Cheonan, KoreaWarfarin is used as part of the treatment of various diseases, and laboratory monitoring of its effects is required. Airway hematoma secondary to warfarin is rare, but can be fatal because of potential airway obstruction. Rapid definitive airway establishment is crucial if airway obstruction is suspected. This complication is more likely to occur in those with elevated coagulation laboratory values. However, we experienced a patient in whom a massive retropharyngeal hematoma caused airway obstruction after a non-severe motor vehicle collision. The patient had been taking warfarin, and had coagulation parameter values within the normal ranges. A major fracture or hemorrhage was not anticipated. Upon examination, a massive retropharyngeal hematoma was noted. Orotracheal intubation failed due to an airway obstruction. Emergency tracheostomy and an operation for hematoma removal were performed. Physicians must always consider the possibility of airway hematoma in warfarin-taking patients with normal coagulation values regardless of the severity of mechanism of injuryhttp://www.jtraumainj.org/upload/pdf/jti-2020-0028.pdfwarfarinanticoagulantshemorrhageairway obstruction |
| spellingShingle | Hyun Young Cho Hyung Il Kim Severe Airway Obstruction due to Massive Retropharyngeal Hematoma in a Warfarin-Taking Patient with a Normal International Normalized Ratio Journal of Trauma and Injury warfarin anticoagulants hemorrhage airway obstruction |
| title | Severe Airway Obstruction due to Massive Retropharyngeal Hematoma in a Warfarin-Taking Patient with a Normal International Normalized Ratio |
| title_full | Severe Airway Obstruction due to Massive Retropharyngeal Hematoma in a Warfarin-Taking Patient with a Normal International Normalized Ratio |
| title_fullStr | Severe Airway Obstruction due to Massive Retropharyngeal Hematoma in a Warfarin-Taking Patient with a Normal International Normalized Ratio |
| title_full_unstemmed | Severe Airway Obstruction due to Massive Retropharyngeal Hematoma in a Warfarin-Taking Patient with a Normal International Normalized Ratio |
| title_short | Severe Airway Obstruction due to Massive Retropharyngeal Hematoma in a Warfarin-Taking Patient with a Normal International Normalized Ratio |
| title_sort | severe airway obstruction due to massive retropharyngeal hematoma in a warfarin taking patient with a normal international normalized ratio |
| topic | warfarin anticoagulants hemorrhage airway obstruction |
| url | http://www.jtraumainj.org/upload/pdf/jti-2020-0028.pdf |
| work_keys_str_mv | AT hyunyoungcho severeairwayobstructionduetomassiveretropharyngealhematomainawarfarintakingpatientwithanormalinternationalnormalizedratio AT hyungilkim severeairwayobstructionduetomassiveretropharyngealhematomainawarfarintakingpatientwithanormalinternationalnormalizedratio |