PRESENTATION
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- Hematemesis: Vomiting of blood or altered blood (“coffee grounds”) indicates bleeding proximal to ligament of Treitz.
- Melena: Altered (black) blood per rectum (>100-mL blood required for one melenic stool) usually indicates bleeding proximal to ligament of Treitz but may be as distal as ascending colon; pseudomelena may be caused by ingestion of iron, bismuth, licorice, beets, blueberries, and charcoal.
- Hematochezia: Bright red or maroon rectal bleeding usually implies bleeding beyond ligament of Treitz but may be due to rapid upper GI bleeding (>1000 mL).
- Positive fecal occult blood test with or without iron deficiency.
- Symptoms of blood loss: e.g., light-headedness or shortness of breath.
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- Hematemesis: Vomiting of blood or altered blood (“coffee grounds”) indicates bleeding proximal to ligament of Treitz.
- Melena: Altered (black) blood per rectum (>100-mL blood required for one melenic stool) usually indicates bleeding proximal to ligament of Treitz but may be as distal as ascending colon; pseudomelena may be caused by ingestion of iron, bismuth, licorice, beets, blueberries, and charcoal.
- Hematochezia: Bright red or maroon rectal bleeding usually implies bleeding beyond ligament of Treitz but may be due to rapid upper GI bleeding (>1000 mL).
- Positive fecal occult blood test with or without iron deficiency.
- Symptoms of blood loss: e.g., light-headedness or shortness of breath.
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