Iatrogenic massive hemorrhagic edema of the tongue: a case report

Abstract

Background Lingual edema is usually the result of infectious etiology, angioedema, and less commonly of traumatic etiology. As for the therapeutic approach, the first priority excluding airway compromise or ensuring airway safety. Antibiotic treatment should be administered for tongue swelling of inflammatory etiology while standard therapy with epinephrine, steroids, and antihistamines is recommended for cases of anaphylaxis. In addition, in case of injury causing lingual edema, one of the treatment options is surgical intervention. Aim of work The aim of our work is to present a rare and simultaneously instructive case of traumatic hemorrhagic edema of the tongue, leading to airway obstruction. Case presentation We report a case of hemorrhagic traumatic lingual edema, initially without symptoms of upper airway obstruction on admission. However, immediate intervention and airway securing was necessary due to rapid growth of the edema. Then, as long as patient was hemodynamically stable and airway patency was ensured, the diagnosis of iatrogenic tongue hematoma was confirmed. The challenge was to decide the appropriate treatment for the patient. Following, she was taken for 24 h to the ICU due to lactic acidosis while the bleeding was treated conservatively. Afterward, she was transferred to the clinic, hemodynamically stable, and was discharged uneventfully. Conclusions Hemorrhagic edema of the tongue may become a life-threatening condition. Its rapid growth can lead to obstruction of the upper respiratory way; therefore, special wariness in its management is required. Treatment can be conservative or surgical, depending on the size and tendency of hematoma to increase.