History

A 67 year-old man was admitted to hospital for surgical ventral hernia repair. He had excessive postoperative bleeding, and was found to have an elevated activated partial thromboplastin time (aPTT; 45 seconds) and normal prothrombin time (PT). His other active medical problems include hypertension, chronic kidney disease and morbid obesity. He also has a 6-7 year history of recurrent iron deficiency anemia requiring periodic intravenous iron. GI work up in the past has revealed the presence of angiodyplastic lesions in the stomach, duodenum and colon. There is no other bleeding history. He had wisdom teeth removed as an adolescent, without incident. There is no family history of abnormal bleeding, elevated PT/aPTT, coagulopathy or other hematological conditions. He is a non-smoker and drinks about 4 beers per week. He works in IT. He is taking lisinopril. He does not have any known allergies to drugs.

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