Hyperfibrinolysis: An Uncommon Cause of Bleeding in Cirrhosis

Abstract

A 57-year-old man with past medical history of alcohol use disorder and cirrhosis presented with right leg pain after a fall at home. Imaging revealed a large right thigh hematoma, and he underwent placement of a Jackson-Pratt (JP) drain by interventional radiology. The hematoma began draining about 100 mL of serosanguineous fluid per day. Laboratory studies showed a hemoglobin of 10.0 g/dL, platelets of 113 k/cm2, international normalized ratio (INR) of 1.5, total bilirubin of 3.8 mg/dL, aspartate transaminase (AST) of 79 IU/L, alanine transaminase (ALT) of 20 IU/L, and alkaline phosphatase (ALP) of 170 IU/L.