Exuberant clot formation following trauma to oral tissues: A case series

Abstract

Background: Exuberant clot formation is a massive postoperative clot formation mimicking a fast enlarging neoplasm after a traumatic episode or complication of oral surgical procedures. This clot tends to increase while oozing blood underneath it. It may occur within 24 to 48 hours and has been referred to as hypertrophic clot and “liver clot”. It presents as an exophytic mass when not inside an extraction socket. Few authors have reported this rarity. This comprehensive case series presents exuberant clot formation following trauma to the oral tissues.

Objective: Cases presented are reports of exuberant clot formation following trauma to the tongue, gingiva, and complications of extraction.

Methods: A prospective study of patients who reported to the maxillofacial surgery department of the dental center, Central hospital Benin, Edo state with complaint of a rapidly increasing bleeding growth in the mouth following trauma or surgery. Data of interest were age, gender, presenting complaint, aetiology, location, drug history, medical history, clinical appearance, investigation and management. Clots were not submitted for histopathological examination. Diagnosis was based on history and presentation.

Results: 7 patients presented with exuberant blood clots slowly oozing blood. Five males and 2 females. Ages were 11, 13, 22, 22, 32, 34 and 45 years old. Laceration of tongue following assault; self-inflicted trauma to gingiva for excision of gingival growth; trauma to gingiva during tooth brushing, and extraction of teeth were causes of trauma. One patient was in her third trimester. Drug history of post coital pill was elicited from second female. Appearance was dusky-red clot with blood oozing from beneath. Management was excision of clot and suturing in 6 of 7 patients.

Conclusion: Exuberant blood clot is a rare complication following trauma. It can mimic a fast growing tumor. Management is by simple excision of clot and suturing of tissues if applicable.

Keywords: exuberant clot, hypertrophic clot, trauma, exodontia