{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T14:28:27Z","timestamp":1762957707865,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,6,6]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>Gastrointestinal, genitourinary and intracranial bleeding are common complications of warfarin therapy. However, airway haematomas can occur in patients with supratherapeutic International Normalised Ratio. The involvement of the airway should be suspected in patients who present with dysphagia, drooling, dysphonia and inability to speak. Conservative management is often sufficient, but a definitive airway, such as endotracheal intubation or a surgical airway, may sometimes be required.<\/jats:p>\n               <jats:p>We present the case of a man in his early 50s who had a haematoma of the hypopharynx causing airway obstruction that was successfully treated with an emergency tracheostomy. We discuss the current guidelines on difficult airway management and the role of a multidisciplinary team in managing imminent airway obstruction.<\/jats:p>","DOI":"10.1136\/bcr-2024-264280","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T13:30:16Z","timestamp":1756387816000},"page":"e264280","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Airway obstruction in a man with warfarin-induced sublingual and pharyngeal haematomas"],"prefix":"10.1136","volume":"18","author":[{"given":"Mohamed","family":"Darwish","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Tawam Hospital, Al Ain, Abu Dhabi, UAE"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fathiya","family":"Al Nagbi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Tawam Hospital, Al Ain, Abu Dhabi, UAE"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamed","family":"Aljanaahi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Tawam Hospital, Al Ain, Abu Dhabi, UAE"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David Olukolade","family":"Alao","sequence":"additional","affiliation":[{"name":"Emergency Department, Plymouth Hospitals NHS Trust, Plymouth, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"2025082806300957000_18.8.e264280.1","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-013-1011-z"},{"key":"2025082806300957000_18.8.e264280.2","doi-asserted-by":"crossref","first-page":"182","DOI":"10.5505\/1304.7361.2014.25594","article-title":"Retropharyngeal Hematoma due to Oral Warfarin Usage","volume":"14","author":"Toker","year":"2014","journal-title":"Turk J Emerg Med"},{"key":"2025082806300957000_18.8.e264280.3","doi-asserted-by":"crossref","DOI":"10.1002\/ccr3.6739","article-title":"Spontaneous sublingual hematoma secondary to warfarin therapy-A rare complication","volume":"10","author":"Adhikari","year":"2022","journal-title":"Clin Case Rep"},{"key":"2025082806300957000_18.8.e264280.4","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jemermed.2023.10.023","article-title":"Oropharyngeal Hemorrhage and Difficult Airway Management: A Decision Not to Intubate","volume":"66","author":"Ramos","year":"2024","journal-title":"J Emerg Med"},{"key":"2025082806300957000_18.8.e264280.5","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1976.00780130099015"},{"key":"2025082806300957000_18.8.e264280.6","unstructured":"Pojaman T . 5. causes affecting supratherapeutic inr of warfarin therapy, its adverse events and management in sawanpracharak hospital. 2016."},{"key":"2025082806300957000_18.8.e264280.7","doi-asserted-by":"crossref","unstructured":"Parvizi S , Mackeith S , Draper M . A rare cause of upper airway obstruction: spontaneous synchronous sublingual and laryngeal haematomas. BMJ Case Rep 2011;2011. doi:10.1136\/bcr.03.2011.3930","DOI":"10.1136\/bcr.03.2011.3930"},{"key":"2025082806300957000_18.8.e264280.8","doi-asserted-by":"crossref","unstructured":"Buyuklu M , Bakirci EM , Topal E , et al . Spontaneous lingual and sublingual haematoma: a rare complication of warfarin use. BMJ Case Rep 2014;2014. doi:10.1136\/bcr-2014-204168","DOI":"10.1136\/bcr-2014-204168"},{"key":"2025082806300957000_18.8.e264280.9","doi-asserted-by":"crossref","first-page":"249","DOI":"10.14797\/mdcj-16-3-249","article-title":"Subtotal Airway Occlusion Due to Sublingual Hematoma in a Patient with Mechanical Aortic Valve on Warfarin","volume":"16","author":"daSilva-deAbreu","year":"2020","journal-title":"Methodist Debakey Cardiovasc J"},{"key":"2025082806300957000_18.8.e264280.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.04.053"},{"key":"2025082806300957000_18.8.e264280.11","doi-asserted-by":"crossref","first-page":"494","DOI":"10.4103\/1947-2714.170606","article-title":"Upper Airway Hematoma Secondary to Warfarin Therapy: A Systematic Review of Reported Cases","volume":"7","author":"Karmacharya","year":"2015","journal-title":"N Am J Med Sci"},{"key":"2025082806300957000_18.8.e264280.12","doi-asserted-by":"crossref","first-page":"83","DOI":"10.5937\/Galmed2306083T","article-title":"New recommendations of the American Association of Anesthesiology (2022) for the management of difficult airway","volume":"2","author":"To\u0161kovi\u0107","year":"2023","journal-title":"Galenika Med J"},{"key":"2025082806300957000_18.8.e264280.13","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aev371"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-264280","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T13:30:18Z","timestamp":1756387818000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-264280"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":13,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,28]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/bcr-2024-264280"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-264280","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]}}}