Melaena

 

Causes

Appropriate Tests

 

The magnitude of acute blood loss and the likely cause should be determined on clinical grounds.

The initial Hb may be normal after acute severe haemorrhage. Full blood count (PCV), Blood group and antibody screen, red cell compatibility testing.

See also Blood transfusion - recipient testing. Endoscopy with biopsy, as appropriate.

See also Rectal bleeding for fresh or occult blood loss.

Gastritis/gastric erosions

 

Gastric ulcer, especially

  • Peptic ulcer
  • Gastric carcinoma

 

Duodenal ulcer

 

Oesophagitis/oesophageal ulcer

 

Oesophageal carcinoma

See under Peptic ulcer.

Vascular malformations

 

Bleeding disorders

Gastrointestinal bleeding is rare, in the absence of a local lesion, or drug effect. However the anticoagulation may contribute to the degree of blood loss and requires reversal in most cases.