warfarin and Biliary-Fistula

Vitamin K deficiency is known to cause impaired coagulation. We report a case of marked prolongation of the prothrombin time-international normalized ratio (PT-INR) associated with warfarin and vitamin K deficiency caused by endoscopic nasobiliary drainage (ENBD).. Oral administration of warfarin was initiated in a 67-year-old man after left hemihepatectomy. He developed a biliary fistula after surgery that was treated by ENBD, which resulted in significant prolongation of the PT-INR.. The effect of warfarin was enhanced in this patient due to reduced absorption of vitamin K as a result of external biliary drainage.

Topics: Aged; Biliary Fistula; Drainage; Drug Interactions; Endoscopy; Hepatectomy; Humans; International Normalized Ratio; Male; Prothrombin Time; Vitamin K Deficiency; Warfarin

Topics: Administration, Oral; Albumins; Animals; Anticoagulants; Barbiturates; Bile; Biliary Fistula; Carbon Radioisotopes; Enzyme Induction; Hepatectomy; Liver; Microsomes, Liver; Rats; Urinary Bladder; Warfarin

Topics: Administration, Oral; Animals; Bile; Biliary Fistula; Carbon Isotopes; Chromatography, Paper; Feces; Injections, Intravenous; Liver; Radioisotope Dilution Technique; Rats; Rats, Inbred Strains; Warfarin