未经证实:孤立的舌下血肿是一种罕见的创伤并发症,严重不受控制的高血压,牙科手术,出血素质,并使用双重抗血小板和抗凝剂。在先进和被忽视的情况下,舌下血肿可能会干扰患者的气道,导致窒息和致命的气道阻塞。我们的目标是在一名70岁的商人中出现一例医源性孤立的舌下血肿,有高血压病史的重度吸烟者。此外,报告文献综述,并组织治疗策略以降低血肿的进展率。除了推荐或建议一项战略计划,以预防颈动脉支架置入期间的这种并发症。
方法:本病例报告符合SCARE标准。我们代表了一名70岁商人的医源性孤立的轻度/中度舌下血肿的病例报告。这种血肿是颈内动脉血管内血运重建的罕见并发症之一,因为在导丝操作或其推进过程中对舌动脉舌下分支的损伤。此血肿采用保守治疗,无任何干预。
未经授权:颈内动脉支架置入手术后,病人突然出现口底疼痛性肿胀。血肿显示口腔底部舌头下方的瘀斑粘膜下肿胀。如果它被放大了,它可能会将舌头推向上颚并阻塞气道,导致严重的气道阻塞.幸运的是,肿胀是孤立的(没有延伸到任何一侧),仅限于舌头的根部和中间三分之一,没有延伸到它的尖端。其发展最可能是由于在手术过程中舌动脉的动脉粥样硬化舌下分支受损。
结论:管理的第一步应该是及时的气道管理。在没有任何进一步干预的情况下进行保守治疗。迄今为止,关于血肿本身的治疗没有共识.大多数情况下,临床医生从观察自发消退开始。当保守治疗不合适时,必须进行手术干预。然而,选择性固定气道是治疗的主要目标。
UNASSIGNED: Isolated sublingual hematoma is a rare complication seen in trauma, severe uncontrolled hypertension, dental operations, bleeding diathesis, and the use of dual antiplatelet and anticoagulant agents. In advanced and neglected cases, a sublingual hematoma may interfere with the patient\'s airway, causing suffocation and fatal airway obstruction. Our objective was to present a case of iatrogenic isolated sublingual hematoma in a 70-year-old business man, heavy smoker with a history of hypertension. Furthermore, to report the literature review, and to organize treatment strategies to reduce the rate of progression of the hematoma. In addition to recommend or advice a strategic plan to prevent this complication during carotid stenting.
METHODS: This case report has been reported in line with the SCARE Criteria. We represented a case report of an iatrogenic isolated mild/moderate sublingual hematoma in a 70-year-old business man. This hematoma developed as one of the rare complications of endovascular internal carotid artery revascularization because of injury to the sublingual branch of the lingual artery during wire manipulations or its advancement. This hematoma was treated by conservative treatment without any intervention.
UNASSIGNED: Immediately after internal carotid artery stenting procedure, the patient developed a sudden onset of painful swelling in the floor of the mouth. The hematoma showing ecchymotic submucosal swelling underneath the tongue in the floor of the mouth. If it became enlarged, it may push the tongue against the palate and blocking the airway, causing serious airway obstruction. Fortunately, the swelling is isolated (has no extension to any side) and limited to the root and middle third of the tongue but, not extending to its tip. Its development most probably due to injured atherosclerotic sublingual branch of the lingual artery during the procedure.
CONCLUSIONS: The first step in management should be prompt airway management. Conservative treatment took place without any further intervention. To date, there is no consensus about the management regarding the hematoma itself. Mostly, clinicians start with observation for spontaneous resolution. When conservative treatment is not appropriate, surgical intervention must be performed. However, electively secure the airway is the main objective for treatment.