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