Acute gastrointestinal bleeding in anticoagulated patients: a prospective evaluation

Acute gastrointestinal hemorrhage is one of the most feared complications of anticoagulation therapy. We prospectively evaluated 18 episodes of acute gastrointestinal bleeding in 17 patients anticoagulated with coumadin or heparin. Endoscopic examination revealed significant lesions irrespective of age, duration of anticoagulation, level of anticoagulation or symptoms. The high frequency of objective findings (e.g., 44% ulcers) suggests that diagnostic endoscopy should be performed in patients with acute gastrointestinal bleeding associated with anticoagulant therapy.