[Dabigatran and emergency operation on a peritonitis patient]

Dabigatran has been introduced into the prevention of stroke in patients with atrial fibrillation. Monitoring of the effect and reversing the action of dabigatran as well as management of an emergency operation and bleeding in a patient who is using the drug is demanding. In such patients, clinical guidelines for the treatment of acute bleeding are based on expert opinions. There is no antidote for dabigatran, but its effect can possibly be partly reversed with recombinant coagulation factor VIIa and dialysis. With increasing use of dabigatran, more frequent severe bleeding complications and problems in emergency operations are to be expected.