Warfarin
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Uncontrolled bleeding in an elderly patient: case report An 82-year-old man experienced postoperative uncontrolled bleeding due to warfarin toxicity. The man had been receiving warfarin [dosage and route not stated] for 5 years, for chronic atrial fibrillation. His medical history included hypertension and aortic arch aneurysm. Following Mohs surgery for basal cell carcinoma in the right infraorbital area, he experienced active bleeding. The man received low dose vitamin K, electrocoagulation of bleeding points and repeated compression; however, bleeding continued for 3 weeks. He subsequently received high-dose vitamin K for 6 days, and bleeding ceased. One week later, he resumed warfarin 2mg daily. At follow-up 9 months later, he was free of complications. Author comment: "[C]hronic ingestion of even small amounts of warfarin (2–5 mg daily) eventually can lead to significant anticoagulation." Jang HS, et al. Warfarin toxicity treated by high dose vitamin K therapy. Journal of Dermatology 39 (Suppl. 1): 101, Jun 2012. Available from: URL: http:// 803074493 dx.doi.org/10.1111/j.1346-8138.2012.01624.x - South Korea
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Reactions 4 Aug 2012 No. 1413
