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The patient was admitted for epistaxis due to therapeutic anticoagulation medication for atrial fibrillation. There is recent history of resection of a mass of the

The patient was admitted for epistaxis due to therapeutic anticoagulation medication for atrial fibrillation. There is recent history of resection of a mass of the vestibule of the mouth with graft repair and radiation therapy. When seen in the physician's office, the patient's Coumadin was discontinued due to high protime. Although the Coumadin was stopped, the protime continued to rise. Protime was corrected with frozen plasma during hospitalization.

Final diagnoses and procedure: (1) Epistaxis secondary to Coumadin, (2) recurrent cancer of vestibule of the mouth, (3) atrial fibrillation.

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