Case of sublingual hematoma threatening airway obstruction.
Bibliographic record
Abstract
BACKGROUND: The complications of warfarin therapy have classically been described as bleeding in the genitourinary and gastrointestinal tracts, skin, central nervous system, nose, penis, or retroperitoneum. However, rarely warfarin may cause bleeding that compromises a patient's airway. A sublingual haematoma is an example of such a complication. Only 10 previous cases of sublingual haematomas have been reported. CASE REPORT: We describe the case of a 56 year-old woman receiving oral anticoagulation who presented with a sore throat and hoarseness. Examination of her oral cavity revealed a soft, red, submucosal swelling involving the floor of mouth and ventral lingual surface bilaterally. No signs of airway compromise were observed. The patient's PT-INR was 10. Given the potential for rapid airway obstruction, the patient was admitted to a unit with closely monitored beds. Her coagulation disturbance was corrected medically and her haematoma resolved. The patient was discharged to the care of her family physician. CONCLUSIONS: This case makes several important points. First, the case describes a rare, but life-threatening complication of warfarin therapy. Second, the initial signs of a sublingual haematoma are reviewed. Given the vagueness of these signs, diagnosis requires a high index of suspicion on the part of the physician. Finally, the case describes successfully management of this disorder without the use of a surgical airway. For this patient, reversal of her anticoagulation and vigilant monitoring saved her from having a surgical airway placed.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".