RT Book, Section A1 Reyes, Sonia M. A1 Bronner, Jonathan A2 Stone, C. Keith A2 Humphries, Roger L. SR Print(0) ID 1176286443 T1 Gastrointestinal Bleeding T2 CURRENT Diagnosis & Treatment: Emergency Medicine, 8e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071840613 LK accessmedicine.mhmedical.com/content.aspx?aid=1176286443 RD 2024/03/28 AB For the majority of patients presenting with gastrointestinal (GI) bleeding, hematemesis, hematochezia, or melena will be the chief complaint. Occasionally, patients may present with only dizziness, weakness, lethargy, angina, or syncope. Upper GI bleeding often presents with vomiting fresh blood (hematemesis), vomiting of dark-colored, granular material (“coffee-ground” emesis), and/or black tarry stools (melena). The passing of blood from rectum (hematochezia) usually indicates bleeding from the lower GI tract. The severity of blood loss must be assessed quickly so that lifesaving therapeutic interventions can be instituted. Factors that increase morbidity and mortality include hemodynamic instability, ongoing symptoms suggesting active bleeding, low initial hemoglobin, age over 65, abnormalities in renal, hepatic, and cardiac function, and other comorbidities.