Ahmad Shukri, Fatin Aisya and Mohammad, Adam and Johari, Ahmad Hafizuddin (2026) Sublingual hematoma secondary to mandibular trauma mimicking Ludwig’s angina: a clinical conundrum. University of Toronto Medical Journal, 103 (1). pp. 39-42. ISSN 0833-2207 E-ISSN 1913-5440
|
PDF (Case Report)
- Published Version
Available under License Creative Commons Attribution. Download (257kB) | Preview |
Abstract
Background Sublingual haematoma, or pseudo-Ludwig’s angina, is a rare but potentially life-threatening condition that mimics Ludwig’s angina. Prompt differentiation between hemorrhagic and infectious etiologies of floor of mouth swelling is crucial for appropriate airway and therapeutic management (Baharloo et al., 2020; Cheng et al., 2021; Marin et al., 2020). Case Report We report the case of a 19-year-old male who sustained mandibular trauma in a motor vehicle accident. He presented with progressive submental swelling, muffled voice, and elevation of the tongue, raising suspicion for Ludwig’s angina. Imaging revealed mandibular symphysis and condylar fractures with sublingual hematoma, but no evidence of abscess or gas formation. Flexible endoscopy showed posterior tongue displacement without laryngeal involvement. The patient was managed conservatively with corticosteroids, antifibrinolytics, and antibiotics. Airway intervention was not required. Definitive surgical fixation of mandibular fractures was performed after clinical stabilization. The hematoma resolved completely without complication. Discussion This case highlights the diagnostic challenge in distinguishing pseudo-Ludwig’s angina from true deep neck infections. While both conditions may present with similar clinical findings, imaging and endoscopy play vital roles in guiding management (Alamoudi & Hariri, 2022; Brotfain et al., 2012). Unlike Ludwig’s angina, sublingual hematomas often respond to conservative therapy and rarely necessitate surgical airway intervention unless rapidly expanding or causing obstruction (Lovallo et al., 2013). Conclusion Sublingual hematoma secondary to mandibular trauma should be considered in the differential diagnosis of floor-of-mouth swelling. Early imaging and interdisciplinary evaluation are essential to avoid misdiagnosis and unnecessary invasive procedures.
| Item Type: | Article (Case Report) |
|---|---|
| Subjects: | R Medicine > RF Otorhinolaryngology |
| Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): | Kulliyyah of Medicine Kulliyyah of Medicine > Department of Otolaryngology - Head and Neck Surgery |
| Depositing User: | Dr Hafizuddin Johari |
| Date Deposited: | 15 Jan 2026 09:44 |
| Last Modified: | 15 Jan 2026 09:46 |
| Queue Number: | 2026-01-Q1707 |
| URI: | http://irep.iium.edu.my/id/eprint/126916 |
Actions (login required)
 |
View Item |
Download Statistics
Download Statistics