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Coagulation disorders and the internist.

In patients with untreated coagulation disorders

  • Procedures, such as endoscopy, can cause
    prolonged bleeding (especially when biopsies
    are performed).
    - Minimally invasive techniques can cause
      hematoma and bleeding.

Acquired von Willebrand disease (AVWD).

  • AVWD can present with dramatic hemorrhage and
    gastrointestinal bleeding in patients
    with angiodysplasia.33, 34
  • Aortic stenosis may cause acquired type II VWS,
    characterized by loss of the largest VWF
    multimers.33
  • AVWD can also be caused by a monoclonal
    gammopathy.35
If you suspect a coagulation disorder, investigate the patient’s bleeding history.


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