Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Obstructive Pharyngo-Laryngeal Hematoma Complicating Oral Anticoagulation: Case Report

Document Type : Case Report

Authors
Maissa Lajhouri
Houda Chahed
Rania Laajailia
Rihab Lahmar
Azza Mediouni
Najeh Beltaief
Department of Otorhinoloaryngology Head and Neck Surgery, La Rabta Hospital, Tunisia.
10.22038/ijorl.2025.82416.3772
Abstract
Introduction:
Spontaneous pharyngo-laryngeal hematoma in patients receiving oral anticoagulants is rare and potentially fatal because of upper airway obstruction. Many risk factors can cause potential hemorrhagic complications, such as drug interactions.
Case Report:
We present the case of a 74-year-old man who was on oral anticoagulation by acenocoumarol and presented with acute laryngeal dyspnea. The final diagnosis of pharyngo-laryngeal hematoma secondary to hypercoagulation was made based on the clinical, biological, and radiological features.
Therefore, conservative management was initiated. Drug interactions between anticoagulants and macrolides were the probable underlying causes of excessive anticoagulation.
Conclusion:
Pharyngo-laryngeal hematoma should be considered in patients receiving anticoagulant therapy with symptoms of upper airway obstruction. Drug interactions may be the underlying cause of hypercoagulation, so medications should be carefully prescribed to these patients.  
Keywords
Airway obstruction
Dyspnea
Acenocoumarol
Drug interaction
Subjects
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Iranian Journal of Otorhinolaryngology
Volume 37, Issue 3
May and June 2025
Pages 165-168