# Effective Non-invasive Treatment of Lingual Hematoma in an End-Stage Renal Disease (ESRD) Patient on Rivaroxaban: A Case Report

## TL;DR

A rare case of a life-threatening tongue swelling in a patient with kidney failure on blood thinner was successfully treated without surgery.

## Contribution

Presents a novel non-invasive treatment approach for lingual hematoma in ESRD patients on rivaroxaban.

## Key findings

- Combination therapy with vitamin K, dexamethasone, tranexamic acid, and prothrombin complex concentrate resolved lingual hematoma.
- Prompt medical management prevented airway obstruction and avoided the need for intubation.
- Case demonstrates successful treatment in a high-risk ESRD patient on anticoagulant therapy.

## Abstract

Lingual hematoma is a rare, life-threatening condition that can obstruct the airway. We report a 73-year-old male with end-stage renal disease (ESRD) who developed lingual hematoma while on rivaroxaban. He presented with odynophagia and significant tongue swelling. Treatment with vitamin K, dexamethasone, tranexamic acid, and prothrombin complex concentrate led to rapid improvement without the need for intubation. This case highlights the importance of prompt medical management to prevent airway obstruction in similar patients.