Complications

Investigate for underlying malignancy (look for gastrointestinal and genitourinary especially). ^b  

Why?

• Diagnostic evaluation of gastrointestinal bleeding and gross haematuria may lead to the diagnosis of previously unknown lesions in one third of patients - half have malignancy ^b
• The most common sites of bleeding for patients on heparin or warfarin are the gastrointestinal tract, the urinary tract, soft tissues, the oropharynx. ^b

Soft tissue or wounds are the commonest bleeding sites

Site b	heparin	warfarin
soft tissue/ wound	31%	21%
GI tract	27%	15%
urinary tract	19%	15%
nasopharynx	6%	35%
intracranial	2%	4%
retroperitoneal	3%	1%