Upper gastrointestinal bleeding is a common cause of hospitalization that can be life-threatening. It occurs at a rate of 100 cases per 100,000 people per year. Common causes are peptic ulcers, esophagitis, esophageal varices, and Mallory-Weiss tears. Management involves stabilizing the patient, monitoring for signs of bleeding and shock, transfusing blood products if needed, and locating the source of bleeding via endoscopy to stop it using methods like cauterization or banding.
3. Upper GI Tract
• Anatomically consists of:
» Mouth
» Pharynx
» Oesophagus
» Stomach
• Upper GI bleeding can include bleeding
from the duodenum up to the ligament of
Treitz, just before the junction between
the duodenum and the jejunum
5. Epidemiology
• Upper GI bleeding is a potentially life-
threatening and remains a common
cause of hospitalisation
• Incidence is 100 cases per 100,000
people per year
• Upper GI bleeds are 4 times more
common than Lower
• Overall mortality rate is 6-10 % overall
6. Upper GI Bleed Presentation
• Upper GI bleeding presents in 2 main
ways:
• Melaena = Black motions/stool
• Haematemesis = Vomiting blood
• Other symptoms:
• Anaemia
• Syncope
• Fatigue
Clinical Indicator Probability of
Upper GI Source
Haematemesis Almost certain
Melena Probable
Haematochezia Possible
Blood-streaked
stool
Rare
7. Melaena
• Melaena comes from the Greek melas
meaning black
• Has a characteristic smell of “altered
blood”
• Tar-like in presentation
• Colour is a result of iron oxidation as
blood moves through ileum and colon
8. Haematemesis
• Bloody vomitus
• Bright red/frank blood
• “Coffee-ground” vomitus
– Haem exposed to stomach acid for some time
– Oxidises
– Takes on dark colour
