Gastrointestinal haemorrhage

Haematemesis, melaena or massive rectal bleeding are dramatic signs of gastrointestinal haemorrhage. It is important in such a case to assess the amount of blood loss and to determine the likely site of bleeding.

• haematemesis indicates bleeding proximal to or including the duodenum
• melaena usually results from upper gastrointestinal bleeding, although right-sided colonic and small bowel lesions can occasionally be responsible
• massive rectal bleeding is usually from the distal colon, rectum or from a major bleeding site higher in the gastrointestinal tract

It is necessary to:

• assess and replace blood loss
• diagnose the source of blood loss
• treat and control of source of bleeding