Sore throat in patients on oral anticoagulation should be taken seriously as it may be an early sign of potentially fatal sublingual hematoma and airway compromise.
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Sore throat may herald airway risk on anticoagulation; this case leaves open incidence and management guidance.
Sublingual hematoma is a rare but potentially fatal complication of oral warfarin sodium. Less than ten cases are reported in the English-language literature with only two of these appearing in the otolaryngologic literature. Spontaneous bleeding into the sublingual and submaxillary spaces creates a "pseudo-Ludwig's" phenomenon with elevation of the tongue and floor of mouth and subsequent airway compromise. Two new cases, along with a review of the literature are presented. Management is directed at prompt control of the airway and reversal of the coagulopathy. Sore throat is a uniform, early complaint that should be taken seriously in any patient receiving oral anticoagulation therapy.
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Cohen et al. (1989) studied this question.
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