2024 Volume 52 Issue 3 Pages 154-157
Angina Bullosa Haemorrhagica (ABH) is a hematogenous blister that can appear in the submucosa of the oral cavity because of sudden vascular collapse. We experienced a case in which a submucosal hemorrhage caused by physical stimulation of the soft palate during the induction of anesthesia led to the development of ABH upon further physical stimulation after the patient had returned to the post-surgical ward. The patient was a 59-year-old man (height, 183 cm ; weight, 68 kg). He was scheduled for tooth extraction and marginal resection under general anesthesia for gingival carcinoma of the left mandible. The surgery was completed in 2 hours and 54 minutes, and the duration of anesthesia was 4 hours and 10 minutes. Approximately five minutes after returning to the post-surgical ward, oral suctioning was performed at the patient’s request. At this time, a hematogenous blister of approximately 10×10 mm was observed on the right side of the soft palate. Five minutes later, the size of the area had expanded to approximately 25×25×10 mm. Concerned about further enlargement, the patient underwent decompression by incision and aspiration. In this case, the soft palate became negatively pressurized by the physical stimulation from the suctioning of the oral cavity after returning to the ward and by the process of draining blood and saliva, resulting in the further expansion of the hematochezia because of submucosal hemorrhage, or ABH. This case reaffirms the need for patient-friendly intraoral manipulation during general anesthesia procedures.
