A BUCCAL HEMATOMA: HOW A DENTAL LOCAL ANESTHESIA ENDS UP IN THE INTENSIVE CARE UNIT
Authors:
Solon Politis, Georgios Chatziantoniou, Saramantos Antonios, Vaia Aikaterini Alexoudi, Konstantinos Paraskevopoulos, Konstantinos Vahtsevanos
Affiliation:
Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
Doi: 10.54936/haoms242p37
ABSTRACT:
Objectives: The local anaesthesia of the maxilla for dental procedures, can accidentally cause a hematoma, if the needle traumatizes vessels and cause extravasation of the blood in soft tissues. In our case, the patient had an active and expanding hematoma, which required immediate surgical treatment under general anaesthesia and intensive care unit (ICU) hospitalization. The aim of our case report is to present the possibility how a usual private dental practice could even end up in the ICU, as also as a literature review of similar cases.
Materials and Methods: A 63-year-old male was referred to the emergency department (ED) of our hospital due to an acute growing right buccal swelling, after he received a local anaesthetic for root canal therapy. After a physical and CT examination, an active, enlarging, and expanding buccal hematoma was revealed. The decision of urgent surgical treatment under general anaesthesia was taken undoubtedly, multiple blood clots were removed, and two arterial branches were ligated. The patient was transferred to the intensive care unit (ICU) to ensure regular post-operative hemodynamic stability and airway protection.
Results: The second post-operative day, the patient was decannulated and continued his hospitalization in the clinic and had an uneventful post-operative course. A medical investigation of coagulation functions was performed, without revealing any anomaly.
Conclusion: An acute active hematoma of the head and neck spaces without coagulation/platelet dysfunction is a rare modality. A simple dental injection could end up in such a situation. If the hematoma is active and no preservative treatment succeeds, we must not underestimate the necessity of an immediate surgical treatment under general anaesthesia. Close observation of these patients is mandatory.
KEY WORDS:
Authors:
Solon Politis, Georgios Chatziantoniou, Saramantos Antonios, Vaia Aikaterini Alexoudi, Konstantinos Paraskevopoulos, Konstantinos Vahtsevanos
Affiliation:
Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
Doi: 10.54936/haoms242p37
ABSTRACT:
Objectives: The local anaesthesia of the maxilla for dental procedures, can accidentally cause a hematoma, if the needle traumatizes vessels and cause extravasation of the blood in soft tissues. In our case, the patient had an active and expanding hematoma, which required immediate surgical treatment under general anaesthesia and intensive care unit (ICU) hospitalization. The aim of our case report is to present the possibility how a usual private dental practice could even end up in the ICU, as also as a literature review of similar cases.
Materials and Methods: A 63-year-old male was referred to the emergency department (ED) of our hospital due to an acute growing right buccal swelling, after he received a local anaesthetic for root canal therapy. After a physical and CT examination, an active, enlarging, and expanding buccal hematoma was revealed. The decision of urgent surgical treatment under general anaesthesia was taken undoubtedly, multiple blood clots were removed, and two arterial branches were ligated. The patient was transferred to the intensive care unit (ICU) to ensure regular post-operative hemodynamic stability and airway protection.
Results: The second post-operative day, the patient was decannulated and continued his hospitalization in the clinic and had an uneventful post-operative course. A medical investigation of coagulation functions was performed, without revealing any anomaly.
Conclusion: An acute active hematoma of the head and neck spaces without coagulation/platelet dysfunction is a rare modality. A simple dental injection could end up in such a situation. If the hematoma is active and no preservative treatment succeeds, we must not underestimate the necessity of an immediate surgical treatment under general anaesthesia. Close observation of these patients is mandatory.
KEY WORDS: