Acute Hematemesis/Melena

Peptic Ulcer Disease (55%)

Other

Esophagitis/Gastritis

Tumor

Mallory Weiss Tear

Benign

Malignant

Blood in vomitus/black, tarry stools

If melena, 5-10% colorectal/small bowel.

Exclude bleeding disorder.

Stress (ICU Setting)

Non-Steroidal Anti-

Inflammatory Drugs

Gastric Acid

Hypersecretion

Zollinger-Ellison Syndrome

Portal Hypertension (15%)

Gastroesophageal varices

Helicobacter Pylori

Retching?