Modern practice of internal medicine with emergency conditions. Management of patients with melena and haematemesis

Abstract

Hematemesis is the vomiting of blood, which may be obviously red or have an appearance similar to coffee grounds. Melena is the passage of black, tarry stools. Hematochezia is the passage of fresh blood per anus, usually in or with stools. Hematemesis, melena, and hematochezia are symptoms of acute gastro-intestinal bleeding. Acute gastrointestinal bleeding is a common medical emergency which carries hospital mortality in excess of 10 %. Bleeding that brings the patient to the physician is a potential emergency and must be considered as such until its seriousness can be evaluated. The goals in mana-ging a major acute gastrointestinal hemorrhage are to treat hypovolemia by restoring the blood volume to normal, to make a diagnosis of the bleeding site and its underlying cause, and to treat the cause of the bleeding as defini-tively as possible.