acenocoumarol and Polyps

Haemobilia is a rare cause of acute upper gastrointestinal bleeding and is often associated with a history of hepatic or biliary tract injury, tumor growth, hepatic artery aneurysm, cholecystitis, or hepatic abscess. We report a case of a 79-year-old women with haemobilia due to acenocoumarol overdosage. She has been, taking 12 mg acenocoumarol by mistake for 5 days before admission because of atrial fibrillation. INR was 20 during an admission. Ultrasonographic evaluation demonstrated hepatomegaly, cholelithiasis, thick sludge in gallbladder represented blood clots and also dilated biliary tract. Cholecystectomy was carried out. The cut section of gall bladder showed stone, haemolysed blood and blood clots. Choledochotomy showed only blood clots within the duct. The treatment lasted long period and patient died because of multiorgan insufficiency in the course of sepsis.

Topics: Acenocoumarol; Aged; Anticoagulants; Atrial Fibrillation; Cholecystectomy; Cholecystitis, Acute; Cholelithiasis; Drug Overdose; Fatal Outcome; Female; Hemobilia; Humans; Medication Errors; Multiple Organ Failure; Pancreatitis; Polyps; Splenectomy; Treatment Failure