Old scars, new bleeds: revisiting coagulopathy in quiescent Crohn’s disease

An elderly patient with quiescent Crohn's disease and prior bowel resection developed severe vitamin K deficiency-related coagulopathy three decades after remission.Selective depression of vitamin K-dependent clotting factors (II, VII, X) with normal factor V and elevated factor VIII was identified, and coagulopathy resolved rapidly with vitamin K supplementation.This case underscores the importance of long-term monitoring for fat-soluble vitamin deficiencies in patients with inflammatory bowel disease with a surgical history, even in prolonged remission.