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Eur J Cardiothorac Surg 2002;21:117-118
© 2002 Elsevier Science NL

Case report

Retropharyngeal hematoma — a rare complication of anticoagulant therapy

Department of Cardiothoracic Surgery, 6th Floor, East Wing, St. Thomas’ Hospital, Lambeth Palace Road, London SE1 7EH, UK

Received 20 July 2001; received in revised form 18 October 2001; accepted 22 October 2001.

* Corresponding author. Tel.: +44-207-922-8005; fax: +44-207-928-5680
e-mail: vnbapat{at}yahoo.com

Anticoagulation is routinely employed in cardiac surgery following mechanical valve replacement. Warfarin is the most common agent used for anticoagulation. Bleeding, internal or external, remains the major complication with anticoagulant therapy. The risk is known to be higher with INR levels above 4.5. We report a case of a retropharyngeal hematoma following trivial blunt trauma to a patient whose INR had shot up to 6.8 and also discuss its management.

Key Words: Retropharyngeal hematoma • Warfarin • Anticoagulation