CASE 12

PATIENT: 23-year-old female

CLINICAL COURSE: status-post cholecystectomy, complicated by retained common bile duct

stones. Following three ERCP procedures to remove stone fragments, she developed hematobilia. She

also required transfusion of RBC’s due to anemia. A prolonged bleeding time of 15 minutes was noted.

MEDICAL HISTORY:

No prior history of blood transfusions or anemia

Lifelong “easy bruising”

Nosebleed treated by cautery, age 10

Irregular menses sometimes lasting a month, with clots

FAMILY HISTORY: Noncontributory

DRUG HISTORY: None

PHYSICAL EXAMINATION:

Grossly bloody stool

No petechiae or ecchymosis

No hepatosplenomegaly

LABORATORY RESULTS:

	Patient	Normal
Prothrombin time	10 seconds	8-11.5 seconds
aPTT	35 seconds	24-37.5 seconds
Platelet count	254,000/μl	150,000-350,00/μl
Bleeding time	15 min	< 9 min

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