Uncontrollable haemorrhage following dabigatran prophylaxis.

An 88-year-old man, on dabigatran anticoagulation after a total hip replacement 1 week before admission, presented with acute abdominal pain associated with malaena and haematemesis. After examination and investigation, he was found to have a perforated viscus and underwent laparotomy. The perforation was surgically repaired, but the patient suffered from a massive haemorrhage during the operation, requiring intensive care admission postoperatively. The patient subsequently deteriorated despite aggressive treatment and died several days later.