However, he presented with severe polycythemia (platelet count: 2600 × 103 μL on postoperative day (POD) 8) and abnormalities of vWF (vWF activity: 46% on POD 17) after surgery, which resulted in bleeding tendency (bleeding from drain insertion site on the day of surgery, epistaxis on POD 14, and hemorrhoidal bleeding on POD 15) despite discontinuation of heparin administration. Here, VWF is linked to epistaxis.