Splenic infarction after reversal of warfarin using Prothrombinex-VF in a patient with a mechanical aortic valve.

A 55-year-old man presented to the emergency department with a 1-day history of upper abdominal pain, haematemesis and malaena on a background of aortic valve replacement and three-vessel coronary artery bypass graft surgery. At the time of admission, his medications included warfarin (target international normalised ratio [INR], 2–3), metformin, gliclazide, ezetimibe, fenofibrate, carvedilol, ramipril, aspirin, omeprazole, duloxetine and tramadol.