Management of acute gastrointestinal hemorrhage in anticoagulated patients.

Bleeding is the major risk associated with anticoagulation therapy. The gastrointestinal tract is the most common site of bleeding. Anticoagulated patients who present with acute gastrointestinal hemorrhage pose great therapeutic challenges. In patients who experience a life-threatening hemorrhage, difficult decisions must be made regarding reversal of anticoagulation, timing of endoscopy and endoscopic therapy, and when to reinstitute anticoagulation. The current literature on the approach to patients who present with major gastrointestinal bleeding while on anticoagulant therapy is reviewed.